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Home My WebLink About19-0521 r i CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 3S6-5040 (319) 3S6-5497 FAX Last 1. Name (REQUIRED) 2. Address (REQUIRED) _ IDENTIFICATION NO. l q —0-5c l - N (Office Use Only) p APPLICATION FOR TAXICAB / MOTORIZED PEDI EWLE QRIVER (Police Department review must be made between 8 a.m�p.rN.; Mond— -Friday) First 3. Contact Information (REQUIRED) Email: \'JE (All written mmunication sent via email) 4a. Driver's License expiration date (REQUIRED) _-0. --7j /Q l n I 'r�( b. Taxicab Business Name (REQUIRED) 5. Prior experience in transportation of passe gers: 4 1!.V\ (R A ) C (lt\C) o Co Middle 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this State or elsewhere? Type of offense C r7(1V4 l o\\, 3 What happened to the charge? (Circle one) W here When Convicted Dismissed Deferred Suspended Plead Guilty Other uio ac SJ app 7. Have you been arrested / charged with any traffic offenses in the last five years? S I -e!L-> Type of offense DO OA What happened to the charge? (Circle one) When Convicted Dismissed Deferred Suspended Plead Guilty Other 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? 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) I _% - 04/2018 .01 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 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 hereby T that I have issued to me by the Iowa Department of Transportation a valid Driver's license number _+ a��3 � issued on \ expiring on --ir to O I understand that if I falsely answer any questions in this application, that this app icat on 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, if authorization to be a taxicab driver ismranted, to comply at all times with all of the provisions of Title 5, Chapter 2, of the City Code. (Needs to be signed in front oft Notary Public) Signature of Applican t"Q1'—Date / T} <M m � STATE OF IOWA ) D COUNTY OF JOHNSON ) C" Subscribedand rn to before me by �) ,' L n �� 1 T7 -,,.ton this day of Si�l,a Zfswo 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 date of Driver's license40 Signatt r�ci 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. Approved application DCI report State certified driving record Website update CIBrkrrAxIDRIVBADGEAPPL92018awnde .DOC Office Use Only as -i5 Date 04/2018 O7t•}ul JIiV 19Y 20191 1.1 4:1/ v Cab UGI IUWA IY 1 WV STATE OF 101ffA jk Criminal 1 Record Request Form Tot IoweDivisionofCriminalUvetigation Support Operations Bumau, I" Floor 215 it. 7" street Des Moines, Iowa 90319 (5I5)725-6066 (515)725-6080 Fax I am reauestine an Iowa Criminal Hisfnry Recnrd Check on: ff><W9 M82N o. 0 / J2 �, 1 �041004 DCI Aoiount Number: 9967-F I Ile IKI lie-1-4— From: Xellow Cab ol,lowa Ci P.O. B ox 428 CD I 11rilIt Name " eiorh c— Iowa Clt , TA. 5 4 tv a--- - �� t (319) 338-9777 tet— -0 M Phone; fT't mmandso p (319) 339-7502 ❑1vtale Tt'emale � .c co � Last Name nrrwmoy) I 11rilIt Name " eiorh Nam.e treoommmdad Bate of Br1irth maodatnry) Gadder =r,&.I, 'Socifl�i Soocuuri (rw mmandso d( � ❑1vtale Tt'emale � (NNtr/mb vlli-f'" l l "4 � �v p Maiver.infor)nation: Without a signed waiver from the subject of rhe regws a com Piet; crilninal history record may not be releasable, per Code olows, Chapter 692.2. For com a crlminal h!s(ory•r�orql fnf9rmatlon, at allow;d by law, f alwayt obtain awaiver s2. nature from the Pqbjpqt of t e Mquest Waivv Release: t hmcby Slve gmmhrion for ft abbvc scawxunr, Mrlcw to oondau m Iowa criminal history (rrcrd Cheek with the Division of C mina) s ain,.ned by the ncrjrPANba releosid at allowea by law, - lnmllgstion CDC), Any WIMM01 hiMly data oonecminpLmo than 's6 wlxtver Siff naww (Dot I As of —,a sasreb of the provided name and data oibirtityevealed' ❑ No Iowa Criminal History. Record found with DCI �1Dwa Criminal Maury Reoord aAzahed,'DC1 # DCT Wdsls-w I DCI -77 (08/25/10) Received Time Jul. 19. E20 9�2:08PM No. 0666 :woJZI M:at'61ea-61--tor Jul 19. 2019 4:1=Cab IOWA No 0752 P. 2 �71�aievea 1".1. 1e Ceb FAX)3193381No. r.J021004 071Ju1,.18.2019 11:.18AMcsb DCI IOWA -.'. 1 (FvilimNo,0372 P. 2)0yo02 STWTR OF IOWA Crimf ad 30afory 3 6wrd Ch tc k. . ' ltegird�Bt•�'Oarm TOAV(-IIL) PAYING FOR 'THIS REQUESTAGAIN, I'I.EASF. RETURN THIS FORM Da A.opauns Number. �9967•F Tor Iowa Dlywan of Criminal Inyesitgadon From, Yellow Cab of Xowa SOPport 00,suona'Buroev, V Floor P,O, Box'428 215 $, 7°Shaer . Des lrfoioog Iowa• $0310 l XoWA owl M 522. o (Gig) >21-12sc (515) 7X5 -60A0 Snz 1 (319) 338,'P77i- Paoaee- 8az:i (319)339-7302 �.. Iam ueetia an10WLCM d t e I rn -0 Aaf Name nund►lo Narhe (mandnmrs�i e a e --,gym , Wa<ver1nj0rM&10n, rViCbont, a alpned wrivor from tT P subjod of Cho mg411 i a &"0lgi* gAzGlnai h[stary lmw may nne be rnieasable, per Coda *flow&, Cbxptor ¢92,2 For comglota crftnlaal h1oM -`--'- - ..._. — - — _ ty.r&aoi•� Informaitoa, wtrrtowad by }a , &Maya W drgr Aidas m I ha )nvee11t1do* DCII. My orb waiver omdal To wnODol aq ldrvabilroN ft4od clink YA dla Dtvid&n 31nd by the = msy ba t= drat rllowdl nyhw. .. 0 m �jIOP�PB+ C11III�iCt3�Qry �Q�'c�t4 sct��laTYxi�3 . (Dat a oi�yj cD As of. a searc}a afthe pravitiedhsme and date afbirthrevealods C O No lows. Qnninai nst.* RFoord found with DC1 a , �� Iowa Crilw; W Mtazy Raowd at(aabe�'Da 0 C r'aLE -j �" cc Q DCt ir,itiala o 1701-77(UaVIo) S�L 06� �oceivei Time Jul, 1;, 0019%.I :%ljr Ido. 9778 eceived Time Ju . 1�. 2019 2:O6Pmm No -0666 ewG.l.j S2t6D 6S0E�St�7Rf Jul. 19. 20 19 4:18NM UCl IOWA No. 0752 P. 3 IOWA CRININAL HISTORY DCS 00619756 NON CONVICTION PAGE 1 OF 2 DATE PRINTED - 2019/07/19 DCI:00619756 NAME: HOAGLIN,ELIZABETH HOAGLIN,ELIZABETH JANE DOB SEX RAC HGT WGT EYE HAIR SIGN POB 19780726 F W 505 150 BLU RED MED IA ADDITIONAL IDENTIFIERS TAT R ANKL TAT OR ARM .CCH RECORD •�" 01 ARRESTED/TAKEN INTO CUSTODY 20001117 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124-401 .-3-DELIVERY SCHEDULE II TRK#: 100080801 0 CHARGE NO- 02 IA STATUTE IA706-1 .m CONSPIRACY TO DELIVER n C_ �Tq TRK#: 100080802 COURT DISPOSITION C.77 AGENCY: IA052015J JOHNSON CO DIST COURT :<OrTi COUNT NO- 01 IA STATUTE: IA124.401(l)(C. O Q N CONTROLLED SUBSTANCE VIOL. i%' t COURT CASE ID: 06521 FECRO56246 cc CHARGE CLASS: NON CONVICTION TRK#: 100080801 SENTENCE DISP E8P DAT DEFERRED JUDGEMENT 20010608 PROBATION 3Y 20010608 DISCHARGED FROM 20030601 DEFERRED JUDGEMENT COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 03 IA STATUTE: IA124.401(1)(C: CONTROLLED SUBSTANCE VIOL. COURT CASE ID: 06521 FECR056246 CHARGE CLASS: NON CONVICTION TRK#: 100080803 SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 20010608 PROBATION 3Y 20010608 DISCHARGED FROM 20030801 DEFERRED JUDGEMENT An arrest without disposition is not an indication of guilt. This record maintained by the Iowa Division Of Criminal Investigation, Bureau of Identification is a public record but can only be released to non -law enforcement agencies by the DCT. Ju 1. 19. 2019 4:1UM DCI IOWA No. 0752 P. 4 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 informacion from the Division of Criminal Investigation. In order to requeet Che release of confidential juvenile records, if any, an application must be filed pursuant to Iowa Code section 232.147(18), Additionally, criminal history data concerning convictions for certain juvenile sex offenses can be found on the Iowa Sex Offender Registry: http://Www.iowasexoffender.com/ . However, even though some information is available on this site, the actual records for juveniles 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 232.147(18). IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD r..a COVERS THE SUBJECT OF YOUR INQUIRY. o DIVISION OF CRIMINAL INVESTIGATION p,•C; C �" C n � cNn +r' Fri rn -v ::*EX fV T� � C,JIGWADOT SMARTER I $I MPLER I (USTOMER DRIVEN WWW.IOW3dOt.gOV Driver & Identification Services PO Box 9204 1 Des Gnomes, IA 50305-92N Plane 51524491241 Fax 515 233 1837 Certified Abstract of Driving Record Inquiry Date: 7/25/2019 DL/ID #: 787PP9173 (IA) CDL Permit Class: None Customer #: 5036102 Class: C CDL Permit Issue None Date: Name: Brown, Elizabeth Jane Audit tt: 2988983 CDL Permit None Expiration Date: Address: 317 Mosswood Ln Issue Date: 07/13/2018 CDL Permit None Endorsements: Expiration Date: 07/26/2023 CDL Permit None Restrictions: City/State: Iowa City, IA 522466114 Endorsements: NONE ID Status: None Mailing 317 Mosswood Ln Restrictions: NONE DL Status: VAL Address: Restriction None CDL Status: None Mailing Iowa City, IA 522466114 Supplement: CDL Permit Status: ELG City/State: Date of Birth: 7/26/1978 CDL Cert Status: None Sex: F CDL Med Status: None History Information c + Convictions .,r.t-J L —n Citation Date Conviction Date ACD Explanation JUIFJ I; CblAlty 02/01/2016 ,03/02/2016 .592 Speed IA —t t7 Chf Aasaw Accidents - Accident involvement indicated does NOT mean the Individual was at fault or Accident Date 01/01/2017 Name: Brown, Elizabeth Jane DL/ID: 787PP9173 (IA) JUR Case Number 'IA [969840 Pursuant to Iowa Code 4321.10, I, Darcy Doty, 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: Name: Brown, Elizabeth Jane DL/ID: 787PP9173 (IA) �. b^ 7/25/2019 AVIV duzzi— Driver & Identification Services Iowa Department of Transportation Name: Brown, Elizabeth Jane DL/ID: 787PP9173 (IA)