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Home My WebLink About20-029IDENTIFICATION NO. LGl -a2-9 i t (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 a IQ East Washinxlon Suecl Failure to cprnpiete the 'reaaired' urtormaiior will result in denial of the application Iowa City. Iowa 52240.1826 (319) 356-5040 17171356-5497 FAX Last First Middle 1. Name (REQUIRED) 2. Address (REQUIRED) YSw"" ^ p 3. Contact Information (REQUIRED) Email: {f�1(�- Q- 4 i� Q t) Cell Phone: ZS q L74 - 4a. Driver's License expiration data (REQUI b. Taxicab Business Name (R�(]UIRED) �AII written oommuOication sent via email) 5. Prior experience in transportation of passengers: V\ tnV\ D 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this State or elsewhere? Type of offense Who VA What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspendedlead Gui Other 7. Have you been arrested /charged with any traffic offenses in the last five years? ��.i f L, ( =U1.1 12t -e Type of offense Where When -63 $ What happened to the charge? (Circle one) -yam Convicted Dismissed Deferred Suspended I G_tt18y. Other 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years?, [l Type of offense Where 9. Have you ever applied to be an Iowa City taxi driver using a different name? If AND When Provide the name(s) 04=18 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 herebycertifythat I have issued to me by the Iowa Depa menl of Transportation a valid Driver's license number ! �V A A 5 4/ issued on £ r ' expiring on 1 �' /" fr. I understand that if I falsely answer any questions in this application, that this appiic tion may be denied. 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 i Date STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and swom to before me by on this day of Notary Public in and for the State of Iowa 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 license //2.6/2o'Z'6 Z �/ Signature P �Chleorgnee Dale 7 ( 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.44 / Signaturh of City Clerk or esignee Date Office Use Only Approved application DCI report State certified driving record Website update G VrAX'OMY GE PP,92 19a. MDOC 04/2018 'Or"""""NOWADOT 40 SMARTER I SIMPLER I CUSTOMER DRIVEN WWWIOWBdOt.90V Orrew 8 10"0WAtim 3*fvites PO Box 9204 I Des Moines. IA 503069204 Phone 51•.234-91241 Fax 51'-239-1837 Certified Abstract of Driving Record Inquiry Date: 6/16/2020 DL/ID n: 999AA5433 (IA) Name: Abernathy, Jamie Class: C CDL Cert Status: Lynn CDL Med Status: None Address: 2406 CATSKILL CT Audit #: 4619393 Johnson ,' IA Issue Date: 03/05/2020 City/State: IOWA CITY, IA Expiration Date: 01/26/2026 522455213 Endorsements: NONE Melling Address: 2406 CATSKILL CT Restrictions: NONE Date of Birth: 01/26/1990 MaNfBq IOWA CITY, IA Sex: F City/State: 522455213 History Information Convictions Customer O: 5188297 ID Status: EXP DL Status: VAL CDL Status: None CDL Cert Status: None CDL Med Status: None Restriction None Supplement: Operating While Intoxicated Citation Date Conviction Date ACD Explanation County 3UR - 04/17/2010 07/29/2010 A20 Deferred Judgment owl Story IA 12/18/2011 04/02/2012 A20 Operating While Intoxicated Johnson ,' IA 04/05/2017 05/03/2017 S93 Speed Johnson 's -IA ' t! Accidents - Accident involvement indicated does NOT mean the individual )was at fault or given a citation. Operating While Intoxicated Test Refusal/Test Failure Violations Sanctions IType IEtfective IEnd IACD (Explanation (Occurrence IJUR Name: Abernathy, Jamie Lynn DL/ID: 999AA5433 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: 6/16/2020 Name: Abernathy, Jamie Lynn DL/ZD: 999AA5433 Driver & Identification Services Iowa Department of Transporation 0B1Jun. 11. 2020110:51AMCob DC[ IOWA Q;AMlS3M2No.4020 P. 1/5voo3 STATE OF IOWA Criminal history Record Check 40 Request Form e Mw or EM 1P1 s to, Iowa DMdM of Ctiadaat Invadgatioa $apport Aperaeions $nreau, in Fkor 215 M Ta 6'troot Dos Mebees, Iowa "sip (519) 72"0" (515) 725-6050 Fax 0112/(a 9d DCI Account Number., 9967-Y Name Ye➢Oie, eif Iowa Address P.O. Box 436 Iowa C! Iowa 53244 Phone& Fn 319.9594142 an: 0 4d'�C.'THW.Ies or 3�',r).Vntlddib aealnebd As ofas}b,l U< a search of the provided name;gij21 date"ofbi:yh teyEgled; o 13 'No Iowa Qimiaal History Roaord found with, I)Ci t, T j n an gyp' Iowa Criminal Mgtorq Record attached, DCI =-77 (updated 06-26.2018) Pogo 1 oft Received Time Jun, 16. 2020 10:23AM No, 3824 Jun, 17. 2020 10:57AM DCI IOWA No.4020 P. 2/5 IOWA CRIMINAL HISTORY DCI 00896006 MTSDENEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED - 2020/06/17 DcI:00896006 NAME• REYNOLDS.JA$IE LYNN DOB SEX RAC HOT WOT EYE HAIR sm POB 19900126 F W 508 112 GRN BLN FAR IA ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y TAT BACK TAT CHEST TAT L WRS TAT R FOOT TAT R WRS CCH RECORD 0,1 ARRESTED/TAKEN INTO CUSTODY 20100417 AGENCY: IA0850000 STORY CO SO CHARGE NO- O1 IA STATUTE IA321J.2(A) OPER VEH WH INT (OWI) / IST OFFENSE TRK#: SB005XBOI COURT DISPOSITION AGENCY: IAOSSOISJ STORY CO.DIST COURT COUNT NO- 01 IA STATUTE• IA321J.2(A) OPER VEH WH INT (OWI) / IST OFFENSE COURT CASE ID! 02551 OWCRO43891 CHARGE CLASS: NON CONVICTION TRK#' SB005XB01 DRUNK DRIVING SCHOOL SUBSTANCE ABUSE EVALUATION SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 20100729 FINE $1250 20100729 COURT COSTS - 20100729 PROBATION lY 20100729 DISCHARGED FROM 20110525 DEFERRED JUDGEMENT 02 ARRESTED/TAKEN INTO CUSTODY 20111218 AGENCY: IA0520400 IOWA CITY UNIV SEC PD CHARGE NO- 01 IA STATUTE IA321J.2(B) OPER VEH WH INT (OWI) / 2ND OFFENSE TRK#: 1A00DDS01 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J.2(B) OPER VEH WH INT (OWI) / 2ND OFFENSE COURT CASE ID: 06521 OWCRO96644 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: IAOODD801 DRUNK DRIVING SCHOOL SUBSTANCE ABUSE EVALUATION SENTENCE DISP EFF DAT Jun.17.2020 10:58AM DCI IOWA DCI 00896006 PAGE 2 OF 2 SUSPENDED JAIL 335D 20120402 JAIL 365D 20120402 FINE $1875 20120402 PROBATION lY 20120402 03 ARRESTED/TAXON INTO CUSTODY 20130607 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- Ol IA STATUTE IA321J.21 DRIVING WHILE LICONSE DRNIED OR REVOXED TRIC# : 1A00GVP01 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321.174A No, 4020 P. 3/5 OPERATION OF NOT'OR VEHICLE WITH EXPIRED LICENSE COURT CASE ID: 06521 SRCR102005 CHARGE CLASS: SCHEDULED TRAFFIC VIOLATION TRK#z 1A0OGVP01 SENTENCE DISP EFF DAT JAIL 2D 20140407 !p FINE $625 20140407 -.7 0 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. Thie response can only include public criminal history data. Under Iowa law, most juvenile records are confidential. confidential juvenile court recorde,_'S If any, cannot be included in this response. A signed release authorisation 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) . \nnnWwiur.inunu4,. Additionally, criminal history data concerning convictions for cectel)q•0" juvenile sex offenses can be found on the Iowa Sex Offender RegieCY'k.:! http://www.iowasexoffender.com/ . However, even though some informaEi6djs 'a available on this site, the actual records for juveniles may still be %i ,.,r., confidential and any confidential juvenile records cannot be provided with-,;}�,;;a 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 FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS RASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. ^ , DIVISION OF CRIMINAL INVESTIGATION eaJun_17_2020.)_10.5BAN Cab DCI low, fAM 19=2N2. 4020 P. j/5 STATE OF IOWA Criminal History Record Check Request Form b DCI Accoimtti timber, 9967-F f12r Fax cvmvleted fomu tn: (ifyylim6te) - Send ixaults to: town Dtyidonotedudgrlinvesittation Name 'Ydidw of IOWA CIN 8uppor, operadulzB Bureun, ]" Floor 21S 8, "><+ Street Addtw P.O. Bor 42g Dee Mataoa, Iowa 503I9 Results are for the provided name (SIS) 721-6066 rnd date of birth on Iona Ct Io$2244 (515) 725-6030 Fax ry Other � wa mum #mes or dates of birth may,,,� at: produce different 1'esults, g� 31919.4142 M (� �+ wru I.QeC Aso! 8 rt5 Owe my� to V••I�'�-.V 0up'laumui�n:�Wui ,. It sem ch ofthe providednye p�11h tJasdfcllifftdofed; tj m s No %gra Criminal m,toffy Raoord found W •� z ee �4 b Ck�utYl Hi9torp' Rxord ttach aext, DCI � l ��, -+I DCZ initials_ . r , _.. +•' fi', Mit• 'r$>' ' Page t oft Received Time Jun, 16 2020 10'23AM No. 3824' Jun. 17. 2020 10:59AM DCI IOWA No, 4020 P. 5/5 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: http://www.iowasexoffender.com/. 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 riled pursuant to Iowa Code section 232.147(18). b h J O cn