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Home My WebLink About20-019/• _1 r t r'tdf�_ 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. &(2-0 l (Office Use 001y) 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 First Middle 3. Contact Information (REQUIRED) Email: in y) kur--r A SkAkQr e'—OQa f ��II Phone: (All written communication sent via`e�il) 4a. Driver's License expiration date (REQUIRED) _ b. Taxicab Business Name (REQUIRED) 5. Prior experience in transporteAon of passengers: 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? What happened to the charge? (Circle one) Convicted Dismissed eferred Suspended Plead Guilty; CiVller 7. Have you been arrested / charged with any traffic offenses in the last five years? Type of offense Where t When /s What happened to the char e? (Circle one) nv' 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? 14 elf Type of offense r Where 1 When 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) (SECOND 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 herebypert' that I have issued to me by the Iowa D partment of Transportation a valid Driver's license number _a 0 _ issued on expiring on a 1 understand that if falsely answer any questions in this application, that this app cat on may be denied. 1 gr a 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 �Qa 6,91 U STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by 702-0 in Commission No. 785030 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 l�riv license �y z Z — Z& Z I7v Signatgk Police Chief or designee i` Z7-Iaza 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 ,-;L -aB -_�-O Date Clerk/TAXIDRIVBADGEAPPL92018emended.DDC 04/2018 c o on jhisM 2 ,� day of ��— 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 l�riv license �y z Z — Z& Z I7v Signatgk Police Chief or designee i` Z7-Iaza 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 ,-;L -aB -_�-O Date Clerk/TAXIDRIVBADGEAPPL92018emended.DDC 04/2018 sZFeL 1.202.0 12:_28PMC� ON IOWA No, 1231 P. 1 _ _ ffaxpis 99e z. __ � ..jozfooz v STATE OF IOWA Criminal History Record Check Request Form k low, Division of Crimiml Invesfigatior Support Operonare Bureau, 10 Floor 219 E. 701 street Des Maines, lows 50919 (515) 7254066 (515) 7254080 Pre ACT AcMount Number: 9967-F Send results tg, ffOspicab�e) . Name cndWv sb of Iowa City Address P.O. Box 428 Tows City, Iowa 52244 rhons 91 98 9777 Fsx 319-359 4142 DCI -77 (updated 06,26-2018) Page 1 oft Received Time Feb, 14. 2020 4:20PM No.0247 Feb.21.2020 12:29PM DCI IOWA t IOWA CRIMINAL HISTORY DCI 01026482 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED - 2020/02/21 DCI:01026482 NAME: BROOKS, SHARONE CSDNTIA DOB SEX RAC HGT WGT EYE HAIR SKN POB 19710922 F B 510 155 BRO ELK MBD IL ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y TAT L CALF TAT R CALF TAT UL ARM TAT OR ARM CCH RECORD *** N CY 01 ARRESTRD/TAKEN INTO CUSTODY 20150518 Ci AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA714.2(4) THEFT 4TH DEGREE - 1978 Y TRK#: 1B000ET01 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT _) cJ COUNT NO- 01 IA STATUTE: IA714.2(4) THEFT 4TH DEGREE -- POa6a6a/ConhvOl Gvar $200 UndaY $500 COURT CASE ID: 06521 SRCRIOBS81 CHARGE CLASS: NON CONVICTION & + d TRK#: 16000ET01 RESTITUTION SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 20150729 PROBATION lY 20150729 DISCHARGED PROM 20170606 DEFERRED JUDGEMENT 02 ARRESTED/TAKEN INTO CUSTODY 20150516 A AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124.401(1)(d)-F CONTROLLED SUBSTANCE VIOL. TRW 1E000RU01 CODRT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA124.401(5) POS399SIQN OF CONTROLLED SUBSTANCE, MARIJUANA IST OFFENSE COURT CASE ID; 06521 FECR108580 CHARGE CLASS: NON CONVICTION TRK#: 1B000ZU01 SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 20151009 PROBATION lY 20151009 DISCHARGED FROM 20161201 DEFERRED JUDGEMENT 03 ARRESTED/TAKEN INTO CUSTODY 20151004 No. 1231 P. 2 N CY Ci o Y r--- _) cJ CO rr— & + d U7 -.J '' , Feb.21.2020 12:29PM DCI IOWA DCI 01026482 PAGE 2 OF 2 AGENCY: IA0520400 IOWA CITY UNIV SEC PD CHARGE NO- 01 IA STATUTE IA124.401(5) POSSESSION OF A CONTROLLED sDBSTANCE TRK#: 1AOOLP201 COURT D18POgIvrom AGENCY: IAGS2015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA124,401(5) POSSESSION OF CONTROLLED SUBSTANCE, MARIJUANA IST OFFENSE COURT CASE ID: 06521 SRCR109012 CHARGE CLASS- MISDEMEANOR CONVICTION TRK#: 1AOOLP201 LICENSE REVOKED SENTENCE DISP EFF DAT JAIL 211 20160301 FINE $315 20160301 COMMUNITY SERVICE MAY PERFORM COMM SERVICE IN 20160301 LIEU OF PAYMENT 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. No. 1231 P. 3 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 C'1� juvenile sex offenses can be found on the Iowa Sex Offender Registry: "{rn--- http://www.iowasexoffender.com/ However, even though some information'l� available on this site, the actual records for juveniles may still be C377 confidential and any confidential juvenile records cannot be provided wi 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(le). IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION TRIS RECORD IS Y BASED ON INFORMATION FURNISHED, ME CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION '',TINA 00T www.iowadot.gov SMARTER I SIMPLER I CUSTOMER DRIVEN DrNu & Id~itition Sarvi[e9 PO Box 92M I Des Moines. IA 60306-M Phare- 515-244-9124 1 Fax 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 2/14/2020 DL/ID #: 68OA37904(IA) Customer #: 6077198 Name: Brooks, Sharone' Class: C ID Status: None Chuntia Address: 1313 KEOKUK ST Audit #: 4517294 DL Status: VAL Issue Date: 01/30/2020 CDL Status: None City/State: IOWA CITY, IA Expiration Date: 09/22/2021 CDL Cert Status: None 522403310 Endorsements: NONE CDL Med Status: None Mailing Address: 905 1/2 N Governor Restrictions: Corrective Lenses Restriction None St Supplement: Date of Birth: 09/22/1971 Mailing Iowa City, IA Sex: F City/State: 522455921 History Information Convictions Citation Date Conviction Date ACD Ex lanation Count ---ir, 31�, ` 10/04/2015 03/01/2016 A33 Drug/Drug Related Johnson IAS 4 i-1 3UR Revoked 04/06/2016 10/02/2016 A33 Drug/Drug IA IA Conviction -A- Sanctions Type Effective End ACD Explanation Occurrence 3UR 3UR Revoked 04/06/2016 10/02/2016 A33 Drug/Drug IA IA Related Conviction Name: Brooks, Sharone' Chuntia DL/ID: 6BOA37904 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 OQp��N£ryr OF 1pfry9-0Ol N, _a i Name: Brooks, Sharone' Chuntia DL/ID: 680AI7904 2/14/2020 A1Vk Driver & Identification Services Iowa Department of Transporation N 0 C N M I y a) t� -{ O Gr -1 O Ya Ln -J