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Home My WebLink About20-009r, IDENTIFICATION NO. 2,(9-009 1 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 (319) 356-5040 Last First Middle (319) 356-5497 FAX 1. Name (REQUIRED) (A r O 2. Address (REQUIRED) `) 8 P+Cr)vo j+ Tower. c .t;2 r=19 2 2 `l 5- 3. 3. Contact Information (REQUIRED) Email Ca rrj olio, cC C Cell Phone: 3/ c/ 321 2 MV (All written communication sent via email) 4a. Driver's License expiration date (REQUIRED) _ .Z (DEC 7n2 7 b. Taxicab Business Name (REQUIRED) V Pl/Ut-✓ Cc, 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? V1 O N Tvceofoffense Where When U 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? v\y Tvce of offense Where When What happened to the charge? (Circle one) 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? 'AO Tvoe 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) X10 (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 heb certify that I have issued to me by the Iowa Department of Transportation a valid Driver's license number ,r0 � 4 1�7I issued on 2OL62ui°t expiring on Z DEC 202 �?. 1 understand that if I 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 Tie 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant U11 /� Date3 ( J&L' 2020 STATE OIOWA TM ) o COUNTY OF JOHNSON Subscribed and sworn to before me by V—_)5-00 Cc. rdovnc� Jf. 01?" C-1715 1 day of 262b %1 n fl C---Y-\-<r— r" 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' se /Z -0 - 2,o Z 7 97 C/- 31-2,,26 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. or Office Use Only Approved application DCI report State certified driving record Website update CIe MIDRNADCFAPPL9201ea�.DDC 0-31-2-0�O Date 0412018 o1LJan.2S.2020:1 9:57AMCab DC[ IOWA Q'AX)319339ZNo.7475 P. 1/21002 STATE OF IOWA Criminal History Record Check Request Form e Mail or Fax completed forma to: lows Division of Criminal Investigation Support Operations Bureau, l" Floor 215 E. 7m Street Dei Moines, Iowa 50319 (515) 725-6066 (515) 7256080 Fax DCT Account Number: 9967-F (ifapplimble) Send results to: Name Y6l1dW!Phb of lows CI Address P.O. Box 428 Iowa City, Iowa $2244 /7 ` Phone (319)338-9771 CrjD Q� Fat 319-3594142 Iowa Cri min ec rd Check Results ;o ff ae may) As of a search of the provided name and date of birth revepj' i ." : ` 0 , . No Iowa Criminal History Record found with DCI : `, O 'o ❑ Iowa Criminal' History Record attached, DCT #., o m DCI initials DCI -77 (updated 06-16.2018) Paye I of 2 Received Time Jan. 22. 2020 11:39AM No.6595 y i Jan -28.2020 9:58AM DCI IOWA No. 7475 P. 2/2 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 confidentlal 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.com/. However, even though some information is available on this site, the actual records for juvenlles may still be confidential and any confidential juvenile records cannot be provided with this record. In order to request the release of confidentlal juvenile records, If any, an application must be filed pursuant to Iowa Code section 232.147(18). N N d C—a 9 rT m 2A r'��g % � l /� ka w�.0 ' _r CI0WA 00T www.iowadotgov SMARTER I SIMPLER I CUSTOMER DRIVEN Driver a tdentriiMatloll $ervkes PO Box 920! I Des Moines. IA 5090642W Plxxie: 515-244.9124 1 Fax 515239-1637 Certified Abstract of Driving Record Inquiry Date: 1/22/2020 DL/ID #: 803YY1531(IA) Customer #: 5073125 Name: Cardona, Dario JR Class: C ID Status: None Address: 418 PETERSON ST Audit #: 4365017 DL Status: VAL Issue Date: 12/02/2019 CDL Status: None City/State: IOWA CITY, IA Expiration Date: 12/02/2027 CDL Cert Status: None c 522455148 ry Endorsements: NONE CDL Med Status: -D None ` Mailing Address: 418 PETERSON ST Restrictions: Corrective Lenses Restriction DE9gne Supplement: Date of Birth: 12/02/1988 r— Mailing IOWA CITY, IA Sex: M �m � City/State: 522455148 C:) ::0 -�Z �J History Information r r CD CLEAR DRIVING RECORD Name: Cardona, Dario JR DL/ID: 803YY1531 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 t 3 OFF+c?AC DDC%3 Name: Cardona, Dario JR DL/ID: 803YY1531 1/22/2020 Driver & Identification Services Iowa Department of Transporation IL— Aydl�j—