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Home My WebLink About20-006r CITY OF IOWA CITY 410 East Washington Street Iowa City. Iowa 52240-1826 (319) 356-5040 (319) 356-5497 FAX 1. Name (REQUIRED) f1 2. Address (REQUIRED) _ IDENTIFICATION NO. 20.00 (c (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 3. Contact Information (REQUIRED) Email: First 4a. Driver's License expiration date (REQUIRED) -51 . ,q_ ' t 5t "Z Z.4 b. Taxicab Business Name (REQUIRED) 61 Prior experience in transportation of pa 0 Middle Phone: 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this Statue Tvce of offense Where --iW an cn O -v 2 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? Type of offense Where When What happened to the charge? (Circle one) Convicted Dismissed 10 U, Ot Defdr d� Suspended "y /? 7'/ 2 o t c 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 ct 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) ti (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 Department of Transportation a valid Driver's license number issued ones' , expiring on ;�! '�` Lr 1 understand that if I falsely answer any questions in this application, that this application may be denied. I1 fagree 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 Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant Date Q�t7 STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by I,QOQQhs C (ll f CA 12-C k on this ) 5 _ day of 0 Notary Public in State Commission No. 785030 'y Commiss on fires �' rouly 14, AW-- r"p j I have reviewed this application, DCI report, and the State certified driving record of this appli[�taanQjjavemined that there is no information which would indicate that the issuance would be detrimental to the safely', health or w6ftre of resi- dents of the City of Iowa City (Title 5, Chapter 2, City Code). o Expiration date of Driver's license S' re of Police Chief or designee 01 -'S' -Z2 if�a 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 Date Clerk/WORNBADGEAPPOM18emended.00C 04/2018 011(oUVcu 14.1a IenowCab 0:4319 338 nun r.uodOO2 Criminal History Reeord Check Request Form Mail orFax Paan. oted frnma to: Iowa Division or Criminal Investigation Support Operations Bureau, 1° Floor 215 E. 71t Street Dee Moines, Iowa 50319 (515)725-6066 (515) 725-6080 Fax DCI ACeOUlit Ndmber. 9967,? (fapplimble) SScmd results to: Name Xall6w�Qab of Iowa C6 Addreas P.O. Sox 418 Iowa Ct, Iowa 522" Phone Q19)339-9777 Fax 319.369-4142 0 DCI -77 (updated 06-26-2018) Page I of 2 Received Time Jan, 8. 2020 2:09PM No.4771 __DISCLAIMER -- 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: htta://www.iowasexoffender.coml, 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). N O N Q O n � Cn r- rn cx = D o J c /,don 10WA00T li SMARTER I SIMPLER I CUSTOMER DRIVEN www.iowadot.goy Driver & kmfvjftxwn Is4rvbas PO Box 92041 Des Moines. IA 50306-9M Phone- 515-244.91241 Fax 515.299-1837 Certified Abstract of Driving Record Inquiry Date: 1/13/2020 DL/ID #: 315AE8387(IA) Name: Manirakiza, Reuben Class: C Restriction —1 Giggs Supplement: c-)-< - Address: 1805 Daleview Or Audit #: 4412096 _ O'er = Issue Date: 12/19/2019 City/State: Marion, IA Expiration Date: 03/12/2020 523025107 zone Endorsements: NONE Mailing Address: PO Box 404 Restrictions: NONE Date of Birth: 03/12/1990 Mailing Cedar Rapids, IA Sex: M City/State: 524060404 History Information Convictions Customer #: 5474839 ID Status: None DL Status: VAL CDL Status: None CDL Cert Status: Ncpg CDL Med StatOs:C--� o No= Restriction —1 X" Norte€ Supplement: c-)-< - -iC7 01/30/2017 �r m a _ O'er = O J Citation Date Conviction Date ACD Explanation County JUR 02/1312016 03/21/2016 592 Seed Linn IA 01/01/2017 01/30/2017 S92 Speed (10 mph & Linn IA under in 35-55 mph zone 11/20/2017 01/02/2018 S92 Speed (10 mph & Benton IA under in 35-55 mph zone 04/10/2018 04/23/2018 B20 Driving While Iowa IA Suspended, Denied, Cancelled Revoked 04/10/2018 04/24/2018 S92 Speed (10 mph & Iowa IA under in 35-55 mph zone 03/25/2019 04/18/2019 S92 Seed Tama IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number JUR 12/01/2015 893079 IA Type Effective End ACD Explanation Occurrence 7UR 7UR Suspended 04/09/2018 04/12/2018 D53 Non -Payment of IA IA Iowa Fine Suspended 10/03/2018 11/20/2018 D53 Non -Payment of IA IA Iowa Fine Suspended 10/03/2018 11/20/2018 D53 Non -Payment of IA IA Iowa Fine Suspended 07/23/2019 12/18/2019 D53 Non -Payment of IA IA Iowa Fine Name: Manirakiza, Reuben Giggs DL/ID: 315AE8387 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: Name: Manirakiza, Reuben Giggs DL/ID: 315AE8387 1/13/2020 Driver & Identification Services Iowa Department of Transporation