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Home My WebLink About20-033CITY OF IOWA CITY 410 East Washin5ton Street Iowa City. Iowa 52240-1826 (319)356-5040 (319)356-5497 FAX 1. Name (REQUIRED) _ REQUIRED) IDENTIFICATION NO. 9 C^ 0 3 3 (Office Use Only) APPLICATION FOR TAXICAB 1 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 1!- 2. Address ( . r 3. Contact Information (REQUIRED) Email:, Ri A ►��!'o/ S� 0Q /li4rr/' (&tJ14one: Wl— t (All written communication sent via email) 4a. Drivers License expiration date (REQU b. Taxicab Business Name (REQUIRED) 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? Type of offense Where When 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? V216-3 Type of offense Where WhenDAI, ,Vf ro We, What happened tothe charge? (Circle one) 'ConActed Dismissed Deferred Suspended Plead Guilty Other 8. Has your drivers license or chauffeurs license been suspended or revo ed in the last five years? dd_ 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) 0 0412018 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 1 have issued to me by the Iowa Departm t of Transportati n a valid Driver's license number false answer a an Al rq 7 ° Issued on ? xpiring on e Z I understand that If I N y questlons in this application, that this appli atio may be denled. I gre 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 Tit a 5, Chapter 2, o City Code. (Needs to be signed In front of a Notary Public) Signature of Applicant – — Date 7 O fM}}##1!#}4##Mff#}!f##i#iif fYF#!kf}#hf ifMR#ihhf#hiMiflihlf#pf IMM#iiRRR}i#Mf#f}M}Y##4#fi##if1MMMRMRRi#H}##MR#f 4i#f41M«MhiMR}f#M STATE OF IOWA 1 COUNTY OF JOHNSON Subscribed and sworn to before me by M«MM«MeMM««««i««MMf«i««««„tfMMM on this day of Nota Public In and for the State of Iowa ... ......... . ...........n+.-Hort„w+f#rttfi✓i««i}«M«RF«ftf}F«tftffMtM«}« 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 II nse 'r Signa Police Chief or designee 12-30- Z(%z.3 e' 1b ZU2O 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. 0412018 ign re of ItyC4 or designe / Dateto /11 1MMtlMfftlllFffRMMftM#fMMtlMMR1f4MW{'11MHMfRM1tMF#M#h4M#iMM«Mttlfat#4MtiMf}tfM4hgfR4iMfMt!}1MfltMtfblftRtfb Approved application Office Use Only – DCI report State certified driving record Website update C) w m aWAXIDMry DOWPLsz 18a nd.d.Doo 0412018 Aug. 6.2020 2:40PM DCI IOWA OWVWcucu ue;tm r®now Cab ffA10i1933021" 9878 P r.6'021002 AdMk STATE OF IOWA Criminal History Record Check Request Form f UWIL DI"don of Comtw lbyw%w ioa Support Op"-Ruone 13aen% in "M 215 8.7° 86mg DaMolnel,la" $0319 ($15) 72"0" (SIS) 725-6m Fax DCI A=vnt Nvmber; 9967-F SMIME(i7faygheable) to b. Nabie Ye11dW-Cab of Iowa Cky Address P.O. Sox 428 Iowa City tows 51244 Phone 33""1 FIX 3x 99-4141 DQ -77 (updal,,k os;26-2018) m Received Time Aug. 5. 2020 9:44AM No. 9588 Page 1 aft Aug. 6.2020 2:41PM DCI IOWA No.987P DISCLAIMER This response can only Include public criminal history data. Under Iowa law, most juvenile records are confidential. Confidentlal juvenlle 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,llwww.jowasexoffender.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 filed pursuant to Iowa Code section 232.147(18). ti a 0 0 C-� D= C= (..� C-) , <� r I o� N t) S -Y W rn 410WADOTwww iowadot. ov SMARTER I SIMPLER I CUSTOMER DRIVEN 9 Drkw A Wantneation smicas PO Boz 92041 Des Moines, IA 6030&92M phone 516244-91241 Fax 515-299-1857 Certified Abstract of Driving Record Inquiry Date: 8/7/2020 DL/ID #: 16BAN5920(IA) Customer #: 6611381 Name: Riner, Shane Class: C ID Status: VAL lUR Christopher Suspended 01/09/2018 02/22/2018 D53 Address: 1100 Arthur St Apt Audit #: 2579258 DL Status: VAL P5 Issue Date: 02/26/2018 CDL Status: None City/State: Iowa City IA Expiration Date: 12/30/2023 CDL Cert Status: None 522406619 Endorsements: NONE CDL Med Status: None Mailing Address: 1100 Arthur St Apt Restrictions: NONE Restriction None PS Supplement: Date of Birth: 12/30/1986 Mailing Iowa City, IA Sex: M City/State: 522406619 History Information Convictions Citation Date Conviction Date ACD Ex lanation 1county JUR 109/03/2017 110/04/2017 B51 No Driver's License Johnson IA Sanctions Type Effective End ACD Explanation Occurrence JUR lUR Suspended 01/09/2018 02/22/2018 D53 Non -Payment of IA IA Iowa Fine C) — s— Name: Riner, Shane Christopher DL/ID: 168AN5920 '07–, Pursuant to Iowa Cade 4321.10, 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: 8/7/2020 Name: Riner, Shane Christopher DL/ID: 16BANS920 Driver & Identification Services Iowa Department of 7ransporation N O P C.J (T