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Home My WebLink About20-0444a. Drivers License expiration date (REQUIRED) I Z - 2 7 Z O -Z- C) b. Taxicab Business Name (REQUIRED) Ye- Zl D of (2v2r(3 7-2w (2-1 �. 5. Prior experience in transportation of passengers: �ct �o-w C r4(3 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this State or elsewhere? AU D Type of offense Where Whafhappenpa:1to the charge? (Circle one) c, Convicted Dismissed Deferred Suspended Plead Guilty 7. Have yoL(t*en arrested / charged with any traffic offenses in the last five years? Type of offense Where What happened to the charge? (Circle one) When Other rU ON C 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? 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) 04/2018 IDENTIFICATION NO. 20 -OLIO l 1 (Office Use Only) APPLICATION FOR TAXICAB / MOTORIZED PEDICAB VEHICLE DRIVER CITY OF IOWA CITY (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. lona 52240-1826 (3 19) 356-5040 Last First Middle 1319) 356-5497 FAX /� ,i�A n C&5tLt--v4 1. Name (REQUIRED) idle -Karma 2. Address (REQUIRED) 2-11() K) 006JQJc S 3. Contact Information (REQUIRED) Email: it(- MM%n 6 `iQZ2C)r JV njj -' c0M Cell Phone: I �7-�,3L SIO 7j (All written communication sent via email) 4a. Drivers License expiration date (REQUIRED) I Z - 2 7 Z O -Z- C) b. Taxicab Business Name (REQUIRED) Ye- Zl D of (2v2r(3 7-2w (2-1 �. 5. Prior experience in transportation of passengers: �ct �o-w C r4(3 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this State or elsewhere? AU D Type of offense Where Whafhappenpa:1to the charge? (Circle one) c, Convicted Dismissed Deferred Suspended Plead Guilty 7. Have yoL(t*en arrested / charged with any traffic offenses in the last five years? Type of offense Where What happened to the charge? (Circle one) When Other rU ON C 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? 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) 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 th t I have Issued to me by the Iowa Department of Transportatlon a valid Driver's license number al �3wz a4a Issued on//•/D`l5 expiring on / 7'Z7 ZU, 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 Title 5, Chapter 2, of the City Cade. (Needs to be signed In front of a Notary Public) Signature of Applicantz-�� -----� Date/O tffttift#4hlKKK#KKkRf RR##41##fti R#*RIIF#K#Y#1#kik#f tRRf#44411tKKfFFFFMIHFFIFF;Ft#1#IFIFFFKHFt#Kf X#Ff #Ki*R4FR#1##KIRK#FKII#KIf#R STATE OF IOWA COUNTY OF JOHNS0I�\ ) Subscribed and sworn 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 real - dents of the City of Iowa City (Title 5, Chapter 2, City Code). Expiration date of Driver's license i- 2z2 =- Signature of Police Chief or designee 1 7-0 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. C.OV1Q Re.1SS�`Q- �L ExP \2)21I2C Signature of City lark or dei tgnee Office Use Only Approved application DCI report ✓ State certified driving record Website update lolls 12f1 1 Date CIeiM/TAXIDRIVOADGEAPPL92016amended.DOC 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 Department of Transportation a valid Driver's license number Q/ 3/3 6 Z[, � Z issued on// -/0 /� expiring on / Z --z-7 ZO. 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 Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant/J Date/d / Z - ZO fff.Hftft111feff.....lf_f_fMifffiflfffifNfffffffffltf1111MYffff#111f1#IRfff lfflfff1f111111111f1ff111f ifffffffH1ff11fff1f1Nf1ffHfffffMflff STATE OF IOWA - ) COUNTY OF J6FiNSQh7. ) c Subscribed an& sworn to before me by on this Notary Public in and for the State of Iowa 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 Driver's license Signature of 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. Signature of City Clerk or designee Date Mt##1MRMtf##!f#flMftltYf##R1Rf##RH#M}t1f1#Yf1f R111ft#R#R!f#f##it###fftRft#t1f RtMRR}ffff}fllf RffR###!f#RMfl MtfflfRMtY###f}f R11#}f1ff M} Office Use Only Approved application DCI report State certified driving record Website update ClerWrAXIDRIVRADGEAPPL92018aff"We .DDC 0412018 IW 1"&W&v PY.v, Pawn l.aV WAAUIII.=I,w r.WL/VVL I STATE OF IOWA Criminal History Record Check Request Form DCI Account Number: 9967-F (if2"Emble) Mail or Fax oample tad founs to: Send results to: Iowa Division of Criminal Investigation Support operations Bureau, l" Floor 215 E. 7� Stmt Des Moines, lows 50319 �� 72$-6066 (Sly 7154060 Fa: f'r - _> Name Y6116wo0ab of lora C1h Address P.O. Box 428 Iowa City, Iowa 52244 Y Phone (319) 336.9777 Fa: 319,359.1142 L�Fi�n=TJI�>f'Lr[rr rnn:ln.,, v.^r: Nra }� ♦ y ,rpt_-'T,..�. .CJI .. L1 J1 1I7'a a !,�K,�-�� '•tlVi.if •"'if ''.i� ._YN:JY �-��+5•�� f E,-__M.��-n'"--.. -rr�,-i'1�.`K a:i.:>�. ' 1 M .i •, i ��1R'•�' n..�.•_• ' 1 .V .//[ {{{ '-�i.... 5 •r ' - s � 1 rtry i. r r olt� rtyn i >..:. ,.•,�':"�!,�. ,� :r, ` `F lie," t' , ' , ^ # N � 1 r � ri 1 A+i I�'� ��/Y,�S�"t,^�{ c�lL�;ll n.. {tI. IiY .y L y• 1 11. �� 1 i!i!! aJLYA;-. M'NtiM nw1. Iowa Criminal Elstow Record Check Resulb As of _ 10 a search of the provided name and date of birth revealods, `\\•1\I\„1lnwnnur \ No Iowa Criminal History Record found ❑ IOWa CdMi3W History Record attachedg �.+ : DCI initials Mitory results /lfdf {Jll DCI -77 (updated W-26-2016) Received Time Oct. 12• 2020 1:51PM No, 8722 ma au ono OF IOWAMPS OCT 12 ZON CRIMINAL INVEST Page 1 of 2 C,JIGWADOT SMARTER I SIMPLER I CUSTOMER DRIVEN WWW'IOW8C10t gOV Drhw & WNItlBeaBoa ielvbee PO Box 9201( Des iAaines. IA SO31MAM Phone 515-244-91241 Fax 515.239-IWI Certified Abstract of Driving Record Inquiry Date: 10/12/2020 DL/ID #: 013BB2642(IA) Customer #: 3959505 Name: Casella, Michael Class: D ID Status: None Peter Jr Address: 2110 N DUBUQUE Audit #: 9563241 DL Status: VAL ST Issue Date: 11/10/2015 CDL Status: None City/State: - IOWA CITY, IA Expiration Date: 12/27/2020 CDL Cert Status: None .. 522451624 -- Endorsements: Chauffeur3 CDL Med Status: None Mailing Address:- 2119N DUBUQUE Restrictions: NONE Restriction None ST- _ Supplement: Date of Birth: 12/27/1956 Malliny IOWA CITY, IA Sex: M City/State: CD 522451624 History Information N Convictions Citation Date Conviction Date ACD Ex lanation Coun JUR 11/01/2009 11/30/2009 S92 Seed Johnson IA 03/11/2020 03/19/2020 S92 Seed Johnson IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number JUR 110/07/2018 1071728 IA Name: Casella, Michael Peter Jr DL/ID: 013BB2642 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 O¢ N,N£ryT OF •A� O �i 1 1� Z Name: Casella, Michael Peter Ir DL/ID: 013BB2642 O C::) N 10/12/2020 Driver & Identification Services Iowa Department of Transporation