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Home My WebLink About20-008�III� CITY OF IOWA CITY IDENTIFICATION NO. 2-O—OO8 (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) 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 Middle (319) 356-5497 FAX / 1. Name (REQUIRED) �� a r1 4v'C Iareyi (P 11 TO /] 2. Address (REQUIRED) �/ S �� C; 4 V e- 3. 3. Contact Information (REQUIRED) Email: Al (. C9 a bM a < <a ✓h Cell Phone: 317 -57 `I - `%q (,b (All written corAmunication sent via email) 4a. Driver's License expiration date (REQUIRED) l D 130 j ;13 b. Taxicab Business Name (REQUIRED) 1/P 11 o cJ co b 5. Prior experience in transportation of passengers: IS V q r S 6. Have you ever been arrested/ charged With any misdemeanors and/or felonies in this State or elsewhere?r—s Tvoe of offense Where When 3�do�e�`ret NarraS��,�,} L�-alu,lle p2=�o� What happened to the charge? (Circle one) �onvict V Dismissed Deferred Suspended Plead Guilty Other 7. Have you been arrested / charged with any traffic offenses in the last five years? AD 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? /V rt 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) Is PAGE FOR 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 De artm nt of Transportation a valid Driver's license number '7 C I c( o 3a � issued on bd 13 ? #piring on 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 Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant �� `, - U�Date /-,)-7- C STATE OF IOWA ) COUNTY OF JOHNSON ) and sworn to before me by ASHLEY AJAY-PLATZ Commission No. 785030 on this Z _? day of JUIy 14, N4u I have reviewed this application, DCI report, and the State certified driving record of this applicant and have detained that there is no information which would indicate that the issuance would be detrimental to the safety,_ hii altlr or welfare of resi- dents of the City of Iowa City (Title 5, Chapter 2, City Code). Expiration date of Driver's license /O - Z o - eG Z 3 C a Signaturof 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. [ad Office Use Only Approved application DCI report State certified driving record Website update Date CIeM A%IDRrv64DGEAFFL9201M.ded.DOC 04/2018 Jan.23.2020 10:56AM DCI IOWA 01/1612020 1338 Yellow Cab No.6788 F, 11 fAM93382nm r.uut1002 STATE OF IOWA Criminal History Record Check Request Form Mad or FpX rgMicted forma to: Iowa Division of Criminal Investipatioa Support Operations Bureau, I^ Floor 215 E. 7m Street Dos Moines, Iowa 50319 (515) 726-6066 (515)735-6080 Fax DCI Account Number: 9967-F (ItapplieWe) Send results to: Mame YOU& Cab of Iowa Cl Address P.O. Box 428 Iowa 21, Iowa 52244 _ Phone 319 338-9777 Fax 319-3$9-4141 Asof asearch o£thevidednatnts..bnddiit�-of 6irth°reArm: al ❑ No Iowa Criminal History Record found with ACI' - Iowa Climiml history Reoord attached, lD�i DClinitials V DCI -77 (updated 06-26-2018) Received Time Jan.16. 9070 1:77PM k6001 n incl aye eely) ITC OF IOWAMPS JAN 16 2020 OF CRIMINAL INVEST Pelle 1 oft Jan.23.2020 10:57AM DCI ICWA No. 6788 K 2/3 IOWA CRIMINAL HISTORY DCI 00818366 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED - 2D20/01/23 DCI:00818366 NAME: BROWN,CLARENCE ANTHONY DOB SEX RAC HGT WGT EYE HAIR SKN POB 19691030 M B SID 225 BRO ELK DRK IL ADDITIONAL IDENTIPIERS PHOTO AVAILABLE: Y TAT R SHLD CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 20071027 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA708.7(4) HARASSMENT / 3RD DEG. - 1989 TRX#: IA002NZ01 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA708.7(4) HARASSMENT / 3RD DEG. - 1989 COURT CASE ID: 06521 SMSM067566 CHARGE CLASS: MISDEMEANOR"CONVICTION TRK#: IA002NZOI SENTENCE FINE $100 02 ARRESTED/TAKEN INTO CUSTODY 20050924 AGENCY: IA0520200 IOWA'CITY PD CHARGE NO- 03 IA STATUTE IA726.6(7) ENDANGERMENT/NO INJURY TRK#: 1AOOS7FO3 DISP EFF DAT 20071028 CHARGE NO- 04 IA STATUTE IA124.401(1)(c) CONTROLLED SUBSTANCE VIOL. TRX#: 1A0057F04 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA124.401(1)(B. CONTROLLED SUBSTANCE VIOL'., COURT CASE ID: 06521 PECRO84031 J i CHARGE CLASS: NON CONVICTION TRX#: 1AD057FOl SUBSTANCE ABUSE EVALUATION SENTENCE p DISP EFF DAT DEFERRED JUDGEMENT $1000 CIVIL PENALTY 20090529 PROBATION 3Y 20090529 DISCHARGED FROM 20150511 DEFERRED JUDGEMENT COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 04 IA STATUTE: IA726.6(7) CHILD ENDANGERMENT/NO INJURY N N _ O o i7 C J i p CJ � l Jan.23.2020 10:57AM DCI IOWA COURT CASE ID; 06521 FECROB4831 CHARGE CLASS: MISDEMEANOR-CONVICTTON TRK#: 1A0057F04 SENTENCE SUSPENDED JAIL 165D JAIL leOD FINE $625 PROBATION 2Y DCI 00818366 PAGE 2 OF 2 DISP EFF DAT 20090529 20090529 20090529 20090529 No. 6788 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 Hata. Under Iowa law, most juvenile records are confidential. Confidential juvenile court records, if any, cannot be included in this response. A signed release authorization 0 is not sufficient to obtain this information from the Division of Criminal.._ rs Investigation. In order to request the release of confidential juvenile C_+ records, if any, an application,. must be filed pursuant to Iowa Cade sectigu __, 232.147(18). IV Additionally, criminal history data concerning convictions for certain _frI 3m� juvenile sex offenses can be found on the Iowa Sex Offender Registry; Cs http://www.lowasexoffender,com/ . However, even though some information 1igr= Y� 1 available on this site, the actual records for juveniles may still he Ocrn confidential and any confidential juvenile records cannot be provided with this record. In order to request the release of confidential juvenile records, 1f any, an application must be filed pursuant to Iowa Code section 232.147(181. P. 3/3 IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECOR,I]w78irc;;y,. BASED ON INFORMATION FURNISHED WE CANNOT CONFIRM OR DENY THAT COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION <` Ail}+L• /l l CIUDDT SMARTER I SIMPLER I CUSTOMER DRIVEN www.iowadot.gou Driver a itlentiftawn servbm PO Box 9001 I Des Milnes, IA 5030542(W Phoney 515-244-91241 Fax 515-239-107 Certified Abstract of Driving Record Inquiry Date: 1/16/2020 DL/ID #: 251CC0327(IA) Customer #: 4643734 12/18/2013 Name: Brown, Clarence Class: D ID Status: EXP Anton Address: 425 KOSER AVE Audit #: 3956382 DL Status: VAL Issue Date: 06/28/2019 CDL Status: None City/State: IOWA CITY, IA Expiration Date: 10/30/2023 CDL Cert Status: None 522463040 Endorsements: Chauffeur 3 CDL Med Status: None V�— Mailing Address: 425 KOSER AVE Restrictions: NONE Restriction NOM Supplement: --' Date of Birth: 10/30/1969 r Mailing IOWA CITY, IA Sex: M City/State: 522463040 History Information r Convictions Citation Date Conviction Date ACD Explanation County JUR 12/18/2013 01/17/2014 B20 Driving While Johnson IA Suspended, Denied, Cancelled Revoked Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number JUR 10/12/2017 1009795 IA 01/26/2018 1029407 IA Name: Brown, Clarence Anton DL/ID: 251CCO327 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. T.. ...:� ... L........4 T 4....... -......J ... --. ♦'- ....-I -. "- 1--- - I- ..... ........ Y4:_ - .T ..1....... 1...... �'► this date: Name: Brown, Clarence Anton DL/ID: 251CCO327 1/16/2020 OL Driver & Identification Services Iowa Department of Transporation N G N O M