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Home My WebLink About19-061,.r 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. I`I "NO, (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 =irh(mewl' igm -7,10 N Dvi,Qrnkly -�ftq .Tow a r ,4y - TA 3. Contact Information (REQUIRED) Email: `I' 14Jf Aiv CO' Cell Phone: (319) 38 3—"6oO (All written communication sent via email) 4a. Driver's License expiration date (REQUIRED) Th $ / atti1 b. Taxicab Business Name (REQUIRED) tellpvj Cab Of T-Ov✓q Ct 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 Why', I ll�r��( TdvJq Cr }fir $ C) Y1 C,\+7r BrvleS V'c assqul� T N Cifl O d rW �' C_ Cl+y s M �x N G.J What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended Plead Guilty Other 7. Have you been arrested / charged with any traffic offenses in the last five years? �j a Type of offense What happened to the charge? (Circle one) Where 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? NO 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) (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) 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 hereby certify that I have issued to me by the Iowa D>partm nt of Transportati n a alid Driver's license number 1 ! U\x ( Ott issued on .g��_L1 expiring on 2 . I understand that 'rf I falsely answer any questions in this application, that this ipplica ion may be denied. I agree that in making this application, 1 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 Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) 14,2020 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 da of 4 i�r' Ic Signa of Police Chief or designee 0P- IQ-Zrv1 0--712--11 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 a erkrTAXIDRK43AMEAWL9201 Bemended.DOC Date 04/2018 g/22/ Signature of Applicant I/'/ Date N O_ 0 � STATE OF IOWA )N �n IL COUNTY OF JOHNSON ) fir* -a M Su scribed and sworn to _ before me by ,I o; i%am �vt�rm iS E✓ n thisN y 2 `� day of v w A Q P ASHLEY A JAY•PLATZ $ Commissbn No. 785030 Notary Publi n Wr thi6 Steite of Iowa 14,2020 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 da of 4 i�r' Ic Signa of Police Chief or designee 0P- IQ-Zrv1 0--712--11 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 a erkrTAXIDRK43AMEAWL9201 Bemended.DOC Date 04/2018 081A0$�_1.2019pL:.06At Cab DCI IOWA fAX)31933809-- 3 5 6 4 P. 1/4g002 OF • 11 inal 11istoryRecord Check '• ',' ar ��'� Request _1, 1 11 0 To: Iowa Dlvislon of Criminal Investigation Support Operations Bureau, l" Bloor 215 E. 7r Street ; bu Molnes, Iowa 5031,9 (315) 725.6066 (915) 725-6080 Fax I am MaUeatirl2 an Town Rrimi„al trier..v„ D ---;-A nt_.,_ DCI Account Number _9967-F (ifappliwbic) N From: Yellow CabotXowaity F.O. Box 428- , c D = .:-1 Iowa City, rLD -522 (319) 338-9 m. v Phone-. 19 Fax; � ) 339-7302 N Las=OfBirth Irst Name mand Madie Name treo .hare) ( _T i� \4 ci�q KI TlatGender andato Social -SecurityNumber (recommended 43 / $q / s gale OFeatale ►�sS - �� _ a7 `C a Waiver ihfOrmatlOh: Without a signed waiver from the subject of the request, a complete criminal history record rpay not be releasable, per Code of Iowa, Chapter 692.2. For oompllete criminal history.recard information, at allowed bylaw, always obtain a waiver signature from the cub ocof the re uest Waiver Release, I heroby Elva prnnisaloa Por rhe.dbove roquo/tina ottia(al to conduct anlowa orlminal Llstory reoord ohook with rho Drolslon oM(.rirdlnal Ines V ddon (oCi). My CH.Inarl history dwa wnw»16g me that is mnintainod by,lha DC'1 ni br re d dg'aliowod by law. Waiver Signature: r4"� /�/J/ As of a search of the provided ❑ No Iowa Criminal History Record found., Iowa Criminal History Aewrd attached, L DCT llutiels DCI -77 (06!25110) Received Time Aug. 2, 2019 6:12AM Nd, 2814 k_11104KtCl 5. r U"hitt. p (DCi u/o onlY) - >e date o birE)I ffavealed: < 'O a •,zt,m DCF-�- ''� o -, Sect o vmi 'rrr'plllmwwniul�tp0to "I Aug. 1.2019 11:06AM DCI IOWA IOWA CRIMINAL HISTORY MISDEMEANOR CONVICTIONS ONLY DCI:00373688 NAME: FUHRMEISTER,TIM FUHRMEISTER, TIMOTHY WILLIAM FURHMEISTER,TIM FURHMEISTER,TIMOTHY WILLIAM DOB SEX RAC HGT WGT 19680815 M W 600 200 ADDITIONAL IDENTIFIERS TAT L ARM TAT L CALF TAT L LEG DCI 00373688 PAGE 1 OF 3 DATE PRINTED - 2019/08/07 EYE HAIR SKN POB BLU BRO FAR IA CCH RECORD *** 01 ARRESTED/TAKEN INTO. CUSTODY 19880403 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- Ol IA STATUTE IA123-46 PUBLIC INTOX TRK#: L33958601' COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA123.46 CONSUMPTION / INTOXICATION - 1978 CHARGE CLASS: MISDEMEANOR CONVICTION TAX#: L33958601 SENTENCE PLEAD GUILTY FINE $25 COURT COSTS $20 02 ARRESTED/TAKEN INTO CUSTODY 19900401 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE SA204-401-3 POSSESSION. SCHEDULE I/MARIJUANA TRK#: L33956701 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA204-401-3 POOOE99 SCHEDULE I/MARIJUANA CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L33956701 SENTENCE JAIL lb CREDIT W/TIME SERVED 8H 03 ARRESTED/TAKEN INTO CUSTODY 19971005 AGENCY: IA0520206 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA708-2A-2B ASSAULT/CAUSE INJURY/DOMESTIC TRK#: 037285101 DISP EFF DAT 19880418 19880418 19880418 DISP EFF DAT 19900703 19900703 No.3564 P. 2/4 N O �n C D _{ G7 Ny-- r) 3 � n <r -a M D = Z fV v 1 w Aug. 7.1019 11:07AM' DCI IOWA No. 3564 P. 3/4 COURT DISPOSITION AGENCY: IA052015J COUNT NO- 01 JOHNSON CO DIST COURT IA STATUTE: IA236-2-2 DOMESTIC ASSAULT CAUSING INJURY COURT CASE ID: 06521 SRCR045754 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 037265101 SENTENCE SUSPENDED JAIL 28D JAIL 30D FINE $250 PROBATION lY DCI 00373688 PAGE 2 OF 3 DISP EFF DAT 19980115 19980115 19980115 19980115 04 ARRESTED/TAKEN INTO CUSTODY 19981104 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA708-2A(20)(3B) ASSAULT WITH INJURY/DOM9STIC/BNHANCED TRK)(; 044597001; COURT DISPOSITION AGENCY: IAOS2015J JOHNSON CO DIST COURT COUNT NO- 01IA STATUTE: IA708-2 ASSAULT CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 044597001 SENTENCE JAIL 1D O n -C ---I M r - m DISP EFF DAT 19990223 r 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.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). 0 ARTS Page I of 2 �,JIOWADOT www.iowadatgov SMARTER I SIMPLER I CUSTOMER DRIVEN Driver & Identification Swirl PO Boz 92041 Des Moines, IA 503069204 Phone: 515244.91241 Fac. 515-2331897 History Information CLEAR DRIVING RECORD Name: Fuhrmeister, Timothy William DL/ID: 713XXI449 (IA) N O Pursuant to Iowa Code §321.10, I, Darcy Doty, Driver & Identification Services, Iowa DepartmentC& Trarsip9rtation, do hereby certify that I am the custodian of the records held by Driver & Identification Services, that this Is &*Ran(Scurat—eyapy of an official record currently in the custody of said office, and that I have been authorized by the DirectTfd efithecIOwa Dg2grrment of Transportation to so certify, C7—G N f.. -i n N In witness whereof, I have caused my signature and the seal of the Department to be set upon to<�umett, at enn y, Iowa this date: ::u = N D _ N Name: Fuhrmelster, Timothy William DL/ID: 713XX1449 (IA) 8/13/2019 A21sem Driver & Identification Services Iowa Department of Transportation http://172.29.254.55/drivers/reports/customerhistorylcertifieddrivingrecord.aspx 8/13/2019 Certified Abstract of Driving Record Inquiry 8/13/2019 DL/ID #: 713XX1449 (IA) CDL Permit Class: None Date: Customer 1833101 Class: D CDL Permit Issue None #: Date: Name: Fuhrmelster, Timothy Audit #: 3050110 CDL Permit None William Expiration Date: Address: 1401 Marcy St Issue Date: 08/01/2018 CDL Permit None Endorsements: Expiration 08/18/2024 CDL Permit None Date: Restrictions: City/State: Iowa City, IA 522402117 Endorsements: Chauffeur 3 ID Status: None Mailing 1401 Marcy St Restrictions: Corrective Lenses DL Status: VAL Address: Restriction None CDL Status: None Mailing Iowa City, IA 522402117 Supplement: CDL Permit ELG City/State: Status: Date of 8/18/1968 CDL Cert Status: None Birth: Sex: M CDL Med Status: None History Information CLEAR DRIVING RECORD Name: Fuhrmeister, Timothy William DL/ID: 713XXI449 (IA) N O Pursuant to Iowa Code §321.10, I, Darcy Doty, Driver & Identification Services, Iowa DepartmentC& Trarsip9rtation, do hereby certify that I am the custodian of the records held by Driver & Identification Services, that this Is &*Ran(Scurat—eyapy of an official record currently in the custody of said office, and that I have been authorized by the DirectTfd efithecIOwa Dg2grrment of Transportation to so certify, C7—G N f.. -i n N In witness whereof, I have caused my signature and the seal of the Department to be set upon to<�umett, at enn y, Iowa this date: ::u = N D _ N Name: Fuhrmelster, Timothy William DL/ID: 713XX1449 (IA) 8/13/2019 A21sem Driver & Identification Services Iowa Department of Transportation http://172.29.254.55/drivers/reports/customerhistorylcertifieddrivingrecord.aspx 8/13/2019 Aug. 7.2019 11:07AM DCI IOWA No.3564 P. 4/4 IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION ti 0 O � D C-) a ::f C= C-) -G N : i C-) ro f r m D� _N w ' \ V r, iii C