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Home My WebLink About19-099IDENTIFICATION NO. )q — D Q� r 1 (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) CITY OF IOWA CITY 410 East Washington street Failure to complete the "required" information will result in denial of the application Iowa City, Iowa 52240-1826 (3 19) 356-5040 Last First (3 19) 3S6-5497 VAX II-- 1. Name (REQUIRED) 61ri 6 U) 2. Address (REQUIRED) o�J`(g D �! 3. Contact Information (REQUIRED) Email: �q Wl�tc e Middle i L, c D Cell Phone: *!319 y X19 7`/90 (All written communicatioirsent via email) 4a. Driver's License expiration date (REQUIRED) y // 11-2-2— �/ b. Taxicab Business Name (REQUIRED) e ffow 22c16 o -F TOL'ua C'f;k fY1 5. Prior experience in transportation of passengers: _J /vlo�t E4S �[ 5 01 �1 ay7-fe T tVt�1 ICC/ M( a 0 5 1 X t02� /.S n ,1 �.:, C,� fv q S e i c4 vim-!' atos-� Lc i4 Jdlow col, 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? What 8. Has your driver's license or chauffeur's license been suspended or Type of offense Where P ael d 13 it Other J�e,lastfiy� ears? J 4lrl._,y �,IJJ When 9. Have you ever applied to bean Iowa City taxi driver using a different natngo-I yes, please provide the name(s) PAGE FOR REQUIRED SIGNATURE AND 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). hereby ertify Shit I ave issued to me by the Iowa Depa ment of Transportatio a v lid Driver's license number q 7 `1 b1 !r issued on l 2 / expiring on // 2�! I understand that if I falsely answer any questions in this application, that this application may be denied. I agree t at 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 provisi0 f�i l ,5�er , C 2, of the City Code. (Needs to be signed in front of a Notary Public) f ,tom Signature of Applicant Date / 7 STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by C `naA V_.�� '. ckc�} ) �c�( c,)�,on this / % day of DeL1-1 A_� 1 n J'+ ° Commimum Number 28428 '1- w««««+«»«r«r�.nnHe«««:«««««««««+«+w+«.«w+,w•«.««o-r+.«.rr.««+++««+«..+««««««eec«:«+«:««+..:.+.....+++.•.:.+•+:«:+«« 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 D ' is' e Signaof Police Chief or designee y-// -a+z2 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. 7i Approved application DCI report State certified driving record Website update Died✓rw°DRNBADGe PLMMe ded.DOC )�-1-7 Date Office Use Only so:6 WV LI -j-.306101 0_1I. -i 04/2018 .a r tF is M t v F Al j x + v � --t =, F'i`i N� n.. {r :1�'1 a '"_ .�. r• t.. r31 i1 . i,r. v .. t .�` -,��:R�i,.✓ y�l 'f .r. � e`.'il� X. � mfr a all 5 _ • . _ sjX;; i i•ri + r F was AS P;o,De•c.-1 1. 2019.11: 03A%,,,k DCI IOWA 319 3666607 ,2/aa/sto,a ,a:ok. 1582„6 P. l.aiooa STATE OF I®i)6'A Criminal History Recoid Check Request Form To: Iowa Division of Criminal Investigation Support Operations Bureau, I' Floor 215 E. 7" Street Des Molnes, Iowa 50319 (515)725.6066 (515)725-605o Fax tic✓C y-//-77 ACI Account Number. 4f l70 �1 - (jrappliesble) From: City of Iowa CI City Clerk's Office 410 E. Washia ton Street Iowa City IA 52UO Phone: 319-3566041 Fax. 31956-5497 on: �611 wMale, ❑Female rralvel LaJorntafton: Without a signed waiver from the subject of the request, a complete criminal history record be releasable, per Code of Iowa, Chapter 692.2. For com I e criminal fdsforyrecord informmay not ee sdon, as allowed by law, always no obfaia a waiver afeuature from the subiect or the ronn{ WaNer RefenSe: l hubby give pumitaim for Me above 0" official's oondua an Iowa aimm'ael hinory,eeoN erect th ect with Division ofCr m nN Inveahpam (DCg. My aiminal hinery dna eonmming official'sj br maybe cele a5 diowe9 by iia. Waiver ftivature: — 1 Iowa Criminal Histor Record Check .c` is (Dcruaeonly) As of a search oftht � • m S e provided Dame ati�(�atei of birth reveale�d�p E OF IOWDP 2 CR luwC.DEC ❑ No Iowa Criminal History Record found with Dot : l i1sto, °. t�•" GPiMI ALIINVES�„ Iowa Criminal History Record attached, DCI # U!.�'� DIV DCI initials DCI -77 (08/25/10) Received Time Dec. 6. 2019 11:15AM No -0960 Dec -11,2019 11:03AM DCI IOWA IOWA CRIMINAL HISTORY FELONY CONVICTION DCIo00507646 NAME: HAMRICK,CHAD HAMRICR,CHADWICK AARON DOB SEX RAC HGT WGT EYE HAIR 19770411 M W 508 165 BRO BLK ADDITIONAL IDENTIFIERS DCI 00507646 PAGE 1 OF 2 DATE PRINTED - 2019/12/11 SKN POB LGT IA No.1582 P. 2 02 ARRESTED/TAKEN INTO CUSTODY 19960902 AGENCY: IA0520200 CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 19950916 AGENCY: IA0920000 WASHINGTON CO SO CHARGE NO- 02 IA STATUTE IA708-7 HARASSMENT TRK#: 022450902 COURT DISPOSITION COURT DISPOSITION AGENCY: IA092015J WASHINGTON CO DIST COURT COUNT NO- 02 IA STATUTE: IA708-7 HARASSMENT COUNT NO- 01 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 022450902 ATTEMPT BURGLARY 2ND SENTENCE DISP EFF DAT FINE $100 19961024 02 ARRESTED/TAKEN INTO CUSTODY 19960902 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- O1 IA STATUTE IA713-6 ATTEMPT BURGLARY 2ND DEG TRK#: 037241001 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: iA713-6(2) ATTEMPT BURGLARY 2ND DEG CHARGE CLASS: FELONY CONVICTION TRK#: 037241001 SENTENCE DISP EFF DAT COURT COSTS 19990226 PROBATION 2Y 19990226 SUSPENDED SY 19990226 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 ACI. 1�IiYM I�t`�� TO � 113 so c6 F11 L I o;o G I 0 " Dec -11.2019 11:03AM DCI IOWA No. 1582 P, 3 This response can only include public criminal history data. Under Iowa law, .mosc juvenile records are confidential. Confidential Juvealle 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 he found on the Iowa Sex Offender Registry; http://www.iowasexaffender.com/ . However, even though ROMO 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 FINOERVRINTS 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 19VESTIGATION VA101 'A113 VM01 )48313 AIIJ - 30 :6 WV L 1330 61OZ 0 3 -11 J - IC CS 11/ • - A 10WA00T SMARTER I SIMPLER I CUSTOMER DRIVEN wmdowadot•gov DrNar B ltlatMricatlon Impel P4 Box 9M i Des Moines. IA 5040&WU PhN* 515-741.91261 FOX 515.299-IB37 Certified Abstract of Driving Record Inquiry Date: 12/10/2019 DL/ID #: 769YY2955(IA) Customer #: 2349835 Name: Hamrick, Chadwick Class: D ID Status: None Aaron Address: 2518 INDIGO DR Audit #: 7661903 DL Status: VAL Issue Date: 01/02/2014 CDL Status: None City/State: IOWA CITY, IA Expiration Date: 04/11/2022 CDL Cert Status: None 522406808 Endorsements: Chauffeur 3 CDL Med Status: None Mailing Address: 2518 INDIGO DR Restrictions: NONE Restriction None Supplement: Date of Birth: 04/11/1977 Mailing IOWA CITY, IA sex: M City/State: 522406808 History Information Convictions Citation Date Conviction Date ACD Explanation County IUR 01/05/2015 02/03/2015 M14 Fail to Obey Traffic Johnson IA Sign/Signal 11/15/2018 12/05/2018 S92 Speed (10 mph & Appanoose IA under in 35-55 mph zone Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number IDR 07 22/2017 994283 IA A k? vMq M414 f14d() q SQ-izus�e- clKK euvsseW 4A 9a ties of +i -"-N e q 14-Q J,t '-7L ^e- wo-�at Q_ vn kwy (p boat ry �hwt� Co. 56t��1� bort �i' �� i n Name: Hamrick, Chadwick Aaron DL/ID: 769YY2955 Pursuant to Iowa Code 5321.10, I, Darcy Doty, Director of Driver & Identifcation Services, Iowa DeOrtment of Transportatiy7 It l r do hereby certify that I am the custodian of the records held by Driver &Identification Services t i4 i a t�ul add 2d�'a e 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. —�t � "! 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: Hamrick, Chadwick Aaron DL/ID: 769YY2955 12/10/2019 A2zz�� Driver & Identification Services Iowa Department of Transporation 101 -X113 d01 1;0:6'j L101051OZ 3-11