The URL can be used to link to this page

Home My WebLink About19-089wig®tl�� t y�®r®Il 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 Q - (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 C� 3. Contact Information (REQUIRED) Email: (All written 4a. Driver's License expiration date (REQUIRED) b. Taxicab Business Name (REQUIRED) 5. Prior experience in transportation of passengers: Middle • t Cell Phone: via email) 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? Type of offense What happened to the charge? (Circle one) Where City Clerk When Convicted Dismissed Deferred Suspended Plead Guilty Other 7. Have you been arrested/ charged with any traffic offenses in the last five years? 11 Where L,„„ C What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspende Plead G 1u I Other 8. Has your driver's license or chauffeur's license been suspended or revoked in the a years? - tln 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) �ek sadI& —S3o(,, 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 pa ment of Transportatio a valid Driver's license number 4:76 �) 7/ H ; ,, q( issued on 1 o'r expiring on o I understand that if I falsely answer any questions in this application, that this ap lice ion may be denied. I a r 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, K authorization to be a taxicab driver is granted, to comply at all times with all of the provisiogs of Tit)Q 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant Date // - Q /- OO/ 9 aaaraaaa:a+aaaaaaaaaaaaaaaaaaaaaa+a+*+++++eae«+eNNaa«a«a+aa«+aaaaaaaa«aaraaaarear<aa:.aa«aaaaaaaaaaaaaaaaaamaaaaaaaaaaatiraaaa«rra::ae STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by�orlv,� �� on this 21 day of k, -'o 201 q. A ASHLEY A JAY-PLATZ My Commission Expires July 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 date of Driver's I' '77 Signa f 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 FILED DCI report State certified driving record Website update NOV 2 1 IM City Clerk Iowa City, Iowa GeARAX1DRPJakDG APPL9101BemaM DOC 04/2018 -_ .,... - TJVJj I`J-"a GIvu STATE OF IOWA Criminal, History Record Check Request Form Account Send results to! (itepplim4le) awa Division of Unnunalve ga on Name Yaljdwabof Iowa CIO Support Operadons Bureau, V Floor 215 R. 711 Street Address P•O, Box 428 Aes Moluee, Iowa 50319 (515) 729-6066 Iowa City, Iowa 52244 (515) 725-6080 Fax 0121119 I am remtestin2-an Iowa Criminal Iiiat&t d;Cheok on: Phone 5319) 338-9777 Fax 319.359.4142 r,vv Ivuz Criminal As of 0-91\-O _! a eoaroh of the provided 6 No Iowa Criruinal History Rsoord found ❑ Iowa Crir i history Record attached, Tr DCI initiale 11 DCI -77 (updated 06-26-2018) Received Time Nov 15. 2019 2:45PM No -6583 ms's ` •. « -. ',in, ,r,CI %o ria i.rimin`L5 STATE ()F IOWAIDPS NOV 15 2019 OF CRIMINAL page 1 oft _ ♦ � :.:- J.i: :.�n-iif`'x C;SY. �.:.'LiYla�1.Pi'Y9'�iU � ! .. ,.:� ] 3 / ( ON1nYo remale 3Y r - 7o - Va)n ' _ASll9"s1gda•�amp�etgclstUfy'iiis-illi6�ltirdtn.y i x MaC t��j K sst�. , � - P t �N�ru1( � .`f�T17^'�• ' l ra�•Jf�'% 1 �J1 t • _ s '� . (° ��p "'° wrt�J �eSSvJGouo(. i 6 ?�Kupa�d 9J� i'n.Jl include ' h 2` �^ .'..�I 1F �G �•.�+ � .i •eYi rF 3 HJYv pp,,�,��,!5f JAY IY a. �� t;l,�� Irlr.Y`-. kk� � fi #•f 1�7i1�y .�r..�1 Criminal As of 0-91\-O _! a eoaroh of the provided 6 No Iowa Criruinal History Rsoord found ❑ Iowa Crir i history Record attached, Tr DCI initiale 11 DCI -77 (updated 06-26-2018) Received Time Nov 15. 2019 2:45PM No -6583 ms's ` •. « -. ',in, ,r,CI %o ria i.rimin`L5 STATE ()F IOWAIDPS NOV 15 2019 OF CRIMINAL page 1 oft DISCLAIMER Tis response can only include public criminal history data. Under Iowa law, most jl venile 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 front 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 thund on the Iowa Sex Offender Registry: httpY1www.iowasexoffender.corrt/. However, even though sortie information is available on this site, the actual records for juveniles may still be confidential and any confidentlal juvenfie records cannot be provided with this record. In order to request the release of confidentiai juvenile records, If any, an application must be filed pursuant to Iowa Code section 232.147(18), 1:1 1 1.-11.- OV 2 11019 City Clerk Iowa City, Iowa .P+ f. C4010WADOT SMARTER I SIMPLER I CUSTOMER DRIVEN www•'owada> gov Dmer 8 MWAlkation 5mbo" PO Box 92D41 Des Moines, IA 503DG921 l phone '515-243-91241 Fax 515-239-1837 Inquiry Date: Name: Address: City/State: 11/19/2019 Sutton, Sabrina Suda 618 S 1st Ave Iowa City, IA 522455204 Mailing Address: 618 S 1st Ave Melling City/State: Sanctions Iowa City IA 522455264 Certified Abstract of Driving Record DL/ID #: 627AH3659 (IA) Customer #: 6013449 Class: C ID Status: EXP Audit #: 4333816 DL Status: VAL Issue Date: 11/15/2019 CDL Status: None Expiration Date: 04/15/2027 CDL Cert Status: None Endorsements: NONE CDL Med Status: None Restrictions: NONE Restriction None Supplement: Date of Birth: 04/15/1981 Sex: F � I �� History Information NOV 2 12019 City Clerk Iowa City, Iowa Type Effective End ACD Explanation Occurrence JUR JUR Suspended 11/16/2016 05/08/2017 D53 Non -Payment of IA IA Iowa Fine Name: Sutton, Sabrina Suds DL/ID: 627AH3659 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: tc. 11/19/2019 Name: Sutton, Sabrina Suda DL/ID: 627AH3659 Driver & Identification Services Iowa Department of Transporation FILE® NOV 2 11019 City Clerk Iowa City, Iowa