The URL can be used to link to this page

Home My WebLink About19-060CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (319) 3S6-5040 (319) 356-5497 FAX 1. Name (REQUIRED) _ IDENTIFICATION NO. IcL—C)U 0 (Office Use Only) APPLICATION FOR TAXICAB / MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be m�de between 8 a.m. to 3 p.m., Monday- Friday) �nlaCilli15 V11:1 CjjY CLLt« Last I�'UA C1�iy. Joll�A Middle JQadl-) T,i 4t - 2. Address (REQUIRED) 3701 Z+, 3. Contact Information (REQUIRED) Email:_ 4a. Driver's License expiration date (REQUIRED) Z Rc�Gca�S/iC,Ira 1.Cp/'CellPhone: written communication sent via email) -63-z's b. Taxicab Business Name (REQUIRED) Oa) (-a6 C w, C, t< 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?� Type of offense Where When L? ":z- ��Ug(-p T- ZxL r/fl acro 1��<�r-euc� Ot�'�ia� 7tCY1 �uSN`ilre 'Ti zl' What happened to the char ' cle one) vi d Dismissed Deferred Suspended Plead Guilty Other 7. Have you been arrested / charged with any traffic offenses in the last five years? .'Vo Type of offense Where When What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended Plead Guilty Other i� 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. (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) 04/2018 Page 2 APPLICATION FOR TAXICAB VEHICLE DRIVER DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERTtFIEp » ...5 DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF Ft'FVlr= IV e You must apply for an individual Department of Criminal Investigation RT,,..� Prim available upon request). "„ . Ufa 15 r'"' aPrt 7 I hereby certify that I have issued to me by the Iowa Department of Transp&di6niA,v4�1( Drivers license number issued on GS-3-/7expiringbn':` ,lQjgt,,, I understand that if 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, if authorization to be a taxicab driver is granted, to comply at all times with all of the provisions of TPd 5, Chapte�2, of the pity Code. (Needs to be signed in front of a Notary Public) Date g� ` STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by Tt,A s . Yk . LA) 00JeN on this _ day of 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 d o cense opi Signature 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. Office Use Only Approved application DCI report State certified driving record Website update CierkrtwnoRivannoceAPPL9201&.ndW.00c 0412018 Aug.13.2019. 8:18AM DCI IOWA 08/07icuia 1L:JJha ran 019301lIavc I No. 4268 P. 1/3 kej „UF/0002 STATE OF �OWA 15 AM If: I rrr 1 1 � Criminal (:4/ t lgS4 11History Request Form CITY CLERK'IOWA CITY. IOWA To: Iowa Division of Criminal Invesligntion Support Opera(lons Bureau, I" Floor 225 E. 7`a Street Des Molnes;7owa $0319 (515) 725-6066 ' (515) 725-60801Fas: I am roauestina an Iowa Criminnl Tdiesnry ta. rl .ter DClAccount Numbcr: ^9967-F (If opplicabla) From: Yellow Cab of Iowa City P.O. Box 428 Iowa. City, I.A. 52244 (319) 338-9777 Phone: Far: (319)' 39-7302 Last Name (mendmo) First Name mandato middle Namc (maemmanJod Iowa Criminal iM t r Regard In ck a I. 111111,p,y,;, 4%4e l Dato of Birth (Inwdalo Gender m�andelo Soeinl-scccuri/i�j Number rocommre^n�ds �/ �_ Z ❑Female a c c' L19Male /. V�`T& L Waiver information: Without a signed waiver from the subjeet of the regUest, n complete griminal history r000rd May no be roleasable, per Code of lows, Chapter 692.2, For;omnlote criminal history,record information, as allowed by taw, always obtain a waiver signature from the Subject of the request, Watver Rd1CaSe: I harchy give pamtisoloo for the pbeva mgmsllpg official to conduct M lowp criminal btstorymeord check with Ne Division of Criminal Invvniptlon (DCO, fully alminal Mmlfy dam oonoamina hal1 molnrolnad ll (I a Del may bo ral000cd.as allowed by low. . Waiver SI�ncture; �� ru}I rngr�c1b01 1:29PM No, 3596 Ug Received Time Ug, / ZV19 Iowa Criminal iM t r Regard In ck a I. 111111,p,y,;, �cl aaa aal» As of �' ` 0�'� "l a search of the provided name azt�e>\t nd4f birth reIvc)il'od. n y a c c' m O ❑ No Iowa Criminal History Record found with DC -1 �rsrr�/yl ` 1.,, . A ez t_1 `+� Y ., Iowa Criminal History Record attached, ACI �! < : ,,.. rn b 1 \; DCI initials ru}I rngr�c1b01 1:29PM No, 3596 Ug Received Time Ug, / ZV19 Aug. 13. 2019 8:18AM DCI IOWA No. 4268 P. 2/3 IOWA CRIMINAL HISTORY; DCI 00626884 MISDEMEANOR CONVICTIONS Ob):Y PAGE 1 OF 2 DATE PRINTED- �� C'� 2019/08/12 LL L DC1:00626889 9 2919 NAME 1, WOODS, JUSTIN MICHAEL C� AUG 15 APi l l: DOB SEX. RAC HGT WGT EYE HAIR SKN POR CIT Y 19820403 M w 507 110 GRN BLK FAR IA rp`f/ CLERK A Ctrl;10WA ADDITIONAL IDENTIFIERS CCH RECORD 01 ARRESTED/TAKEN INTO CUSTODY 20000813 AGENCY: IA0310000 DUBUQUE CO SO CHARGE NO- 01 IA STATUTE IA321J-2 OWI TRK#: 053786401 COURT DISPOSITION AGENCY: IA031015J DUBUQUE CO DIST .COURT COUNT NO- 01 IA STATUTE: IA321J-2 Owl CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 053758401 DRUNK DRIVING SCHOOL SUBSTANCE ABUSE EVALUATION SENTENCE DISP EFF DAT JAIL 2D 20010411 FINE $1.000 20010411 PROBATION 2Y 20010411 SUSPENDED 901) 20010411 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 DCI. 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 232.147(18). Additionally, criminal history data concerning convictions for certain juvenile sex offenses can be found on the Iowa Sex Offender Registry; http://www.iowaeexOffender.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 Aug.13.2019 8:19AM DCI IOWA I No. 4268 P. 3/3 BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION _ 2019 AUG 15 AM I I * 15 CITY CLERK 10WA CITY, IOWA of S N story Cry171711fi ,��x: sto y f.F,"ZU(ts:-* La �. �.. nn ,,� ARTS Page 1 of 2 C4010WADOT�D}p ww SMARTER I SIMPLER I (USTOMER DRIVEN w'I0 ad " PO Box gm I Des = Prow 315244-91241 Fiar-3V li WA CITY. IOWA Certified Abstract of Driving Record Inquiry 7/23/2019 DL/ID #: 705XX9421(IA) Date: Customer 1409870 Class: C Name: Woods, Justin Michael Audit #: 1786839 Address: 3701 2ND ST TRLR 29C Issue Date: 05/03/2017 Expiration 04/03/2025 History Information CLEAR DRIVING RECORD Name: Woods, Justin Michael DL/ID: 705XX9421 (IA) CDL Permit Class: None CDL Permit Issue None Date: CDL Permit None Date: City/State: CORALVILLE, IA Endorsements: NONE Endorsements: 522413250 CDL Permit Mailing PO BOX 5264 Restrictions: NONE Address: EXP Restriction None Mailing CORALVILLE, IA Supplement: City/State: 522410264 Date of 4/3/1982 Birth: Sex: M History Information CLEAR DRIVING RECORD Name: Woods, Justin Michael DL/ID: 705XX9421 (IA) CDL Permit Class: None CDL Permit Issue None Date: CDL Permit None Expiration Date: None CDL Permit None Endorsements: CDL Permit None Restrictions: ID Status: EXP DL Status: VAL CDL Status: None CDL Permit ELG Status: CDL Cert Status: None CDL Med Status: None Pursuant to Iowa Code §321.10, 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: Woods, Justin Michael DL/ID: 705XX9421 (IA) 7/23/2019 d9 - �"- Driver & Identification Services Iowa Department of Transportation http://172.29.254.55/drivers/reports/customerhistory/certifieddrivingrecord.aspx 7/23/2019