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Home My WebLink About19-04941 CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (319)356-5040 (319) 356-5497 FAX 1. Name (REQUIRED) _ 2. Address (REQUIRED) IDENTIFICATION NO. ( 01i - Oq' (Office Use Only) APPLICATION FOR TAXICAB / MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday) Failure to complete the "required" information will result in denial of the application Last First Middle 3. Contact Information (REQUIRED) Email: 4a. Drivers License expiration date (REQU b. Taxicab Business Name (REQUIRED) 5. Prior experience in transportation of passengers: 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? Where What happened to the charge? (Circle one) When Convicted Dismissed Deferred Suspended Plead Guilty Other Have you been arrested / charged with any traffic offenses in the last five years? ` 1 C J What happened to the charge? (Circle on!:ises:e�dDeferred Convicted DisSuspended Plead Guilty Other 8. Has your driver's license or chauffeurs 1 been suspended or revoked in the last five years? n�(� Type of offense Where When 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) NU I AKY) 04/2018 Page 2 APPLICATION FOR TAXICAB VEHICLE DRIVER DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERTIFIED DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF REVIEW You must apply for an individual Department of Criminal Investigation Report (form available upon request). I ert' tha1t'I have issued to me by the Iowa De artment of Transporttion a valid Driver's license number f issued on expiring on �. I understand that if I falsely answer any questions in this application, that this application may be denied. I agree that in making this application, I consent to allow agents or employees of the City of Iowa City, Iowa, in their discretion, to examine any and all records and documents relating to this application, and I further agree that, 9 authorization to be a taxicab driver is granted, to comply at all times with all of the provisions of Title 5, Chapter 2,�offthe City Code. (Needs to be signed in front of a Notary Public) Signature of Applican Date STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by .V k� on this r�vday of of Iowa tkMM*1tk#tk*lltRRft1e41Mfifk#kkRifYM�4*tYt1,'RH1eHMfk14t4#MftklYlY�#1'4itRkl�l11f4frf1Yh41t}1(ItlelMktYfMiM*R/eRRfl44ilR*1fe1M1fffffkWt M I have reviewed this application, DCI report, and the State certified driving record of this applicant and have determined that there is no information which would indicate that the issuance would be detrimental to the safety, health or welfare of resi- dents of the City of Iowa City (Title 5, Chapter 2, City Code). Expiration 7atve'Ki n s e I Z " � � � 73 Signatu, of Police Chief or designee Date AFTER APPROVAL BY THE CITY CLERK YOU ARE AUTHORIZED TO DRIVE A TAXICAB IN IOWA CITY FOR NO MORE THAN ONE YEAR FROM THE DATE LISTED BELOW. or Office Use Only Approved application DCI report State certified driving record Website update Clerk/rA%IMMADGE PPL9201Bem ded.DOC 6--2—a-19 Date 04/2018 •t` SMARTER I SIMPLER I CUSTOMER DRIVEN IfV1M1lIlU'If]lNBdI}t'gt7V Driver B ldotttifreation sm5c*s Pd Box 9264IDes fd rImIA5130&92U Phoney 515-243-9924 1 Fax' S IS29SAW Certified Abstract of Driving Record Inquiry Date: 6/12/2019 DL/ID #: 892AL2024(IA) Customer #: 6335433 Name: Bell, Brandi Yolanda Class: C ID Status: VAL Address: 2510 BARTELT RD Audit #: 2537020 DL Status: VAL APT 2D Issue Date: 02/09/2018 CDL Status: None City/State: IOWA CITY, IA Expiration Date: 12/26/2023 CDL Cert Status: None 522462716 Endorsements: NONE CDL Med Status: None Mailing Address: 2510 BARTELT RD Restrictions: Corrective Lenses Restriction None APT 2D Supplement: Date of Birth: 12/26/1978 Mailing IOWA CITY, IA Sex: F City/State: 522462716 History Information Convictions Citation Date conviction Date ACD Ex lavation Count ]UR 107/2S/2017 109/18/2017 IS92 I Seed Johnson IIA Name: Bell, Brandi Yolanda DL/ID: 892AL2024 Pursuant to Iowa Code §321.10, I, Darcy Doty, Director of Driver & Identification Services, Iowa Department of Transportation, do hereby certify that I am the custodian of the records held by Driver & Identification Services, that this is a true and accurate copy of an official record currently in the custody of said Office, and that I have been authorized by the Director of the Iowa Department of Transportation to so certify. In witness whereof, I have caused my signature and the seal of the Department to be set upon this document, at Ankeny, Iowa this date: 6/12/2019 C Driver & Identification Services Iowa Department of Transporation Name: Bell, Brandi Yolanda DL/ID: 892AL2024 061j:.� Ill 20 19 � 1:315M UC 1 IOWA ff1W319998 No. 6188 P. 10021002 F N • � 1 STATE OF IOWA C AMi rlftl History Record Cheek ° XRegUest Porra WatverXrafp/nrnYipn; 'Without a signe be releasable, per Code of lova, Chapter Waiver Release: I hmbygive p=L'WJba Investigation (OCU. Any edminal hlstmy dam c� Waiver sloalari.'; ❑Male DCT Acaoupt Number.,,_9967-F .. (Ifaepumbte> . Brom: Yellow Cabofflowa-City — --- �'.O.23ox 426 rowa City, 74. 52244 (319) 338-9777 Phone; gax, (319)339-7302 S3to.�B2 7qc�� w rrom the subject of -the request' a complete Srlminal hLstory recotA iQey net For wmnlete criminal history.i-ecord in(ormation, as allowed by law, always oDSclel to conduct anlowt crtminal,b(rmry repord oheokwith she Dlvlrlan of Crlmiwd tined by the I1f:1 maJ be released asalloweg by law, a� •. dna\ •,• ;t g tDC eonlYl As of CO) S � a search; of the provided namJad date oi�Yi\oeillt - \044 t. a c m 33 a C i p 1 No Iowa Criminal-Matoij! Record found withVI'di ya n o- - �. 0 <•' ro rZ �'ti • _ � (� ❑ ,gnnmmui�mcoutu�e. io Iowa Cxiininal afta T;istozy Reooxd ched,'DCI # < co DCI initials • a `' ACI -77 (GMS/I05 Received Time Jun, 12, 2019 10:34AM No, 5154 TO; Iowa Ulvlsicn of Crlmtnai Invesugstlon -- --------�apPort;AperatasnsBnrean;l8f?1aaF - 215 E, 76 Street V. Des Maines, Iowa So3I9 (SYS) 77.5-6D66 �'• (815) 725-6080 $'ax � I am reanenrih& .� s...... WatverXrafp/nrnYipn; 'Without a signe be releasable, per Code of lova, Chapter Waiver Release: I hmbygive p=L'WJba Investigation (OCU. Any edminal hlstmy dam c� Waiver sloalari.'; ❑Male DCT Acaoupt Number.,,_9967-F .. (Ifaepumbte> . Brom: Yellow Cabofflowa-City — --- �'.O.23ox 426 rowa City, 74. 52244 (319) 338-9777 Phone; gax, (319)339-7302 S3to.�B2 7qc�� w rrom the subject of -the request' a complete Srlminal hLstory recotA iQey net For wmnlete criminal history.i-ecord in(ormation, as allowed by law, always oDSclel to conduct anlowt crtminal,b(rmry repord oheokwith she Dlvlrlan of Crlmiwd tined by the I1f:1 maJ be released asalloweg by law, a� •. dna\ •,• ;t g tDC eonlYl As of CO) S � a search; of the provided namJad date oi�Yi\oeillt - \044 t. a c m 33 a C i p 1 No Iowa Criminal-Matoij! Record found withVI'di ya n o- - �. 0 <•' ro rZ �'ti • _ � (� ❑ ,gnnmmui�mcoutu�e. io Iowa Cxiininal afta T;istozy Reooxd ched,'DCI # < co DCI initials • a `' ACI -77 (GMS/I05 Received Time Jun, 12, 2019 10:34AM No, 5154 f Jun. id. 2U19 1:31NM UCl IOWA No. 6188 P. 2 DISCLAIMER 'This response can only include public criminal history data. Under Iowa law, most juvenile records are confidential, .Confidential juvenile court records, if any, cannot be included in this response. A signed release authorization is not sufficient to obtain this information from the Division of Criminal Investigation. In order to request the release of confidential juvenile records, if any, an application must be filed pursuant to Iowa Code section 232.947(18). Additionally, criminal history data concerning convictions for certain juvenile sex offenses can be found on the Iowa Sex Offender Registry: hit D:11wwW-ioWasaxofFender.com/. However, even though some Information Is available on this site, the actual records forjuvenlles may still be confidential and any confidential juvenile records cannot be provided with this record. in order to request the release of confidential juvenile records, if any, an application must be filed pursuant to Iowa Code section 232.947(18).