The URL can be used to link to this page

Home My WebLink About20-054► r CIT` O IOWA CITY 410 Eas( byasliinglon Slreel lona City. lama 52240-1826 13 19) 356-5040 1319) 356-5497 FAX 1. Name (REQUIRED) _ IDENTIFICATION NO. 20 _ O (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) Failure to complete the "required" information will result in denial of the application Last_ First e - Middle I 31 e Q, tsM lk1(�, E --,CSV L 2. Address (REQUIRED) LI U k 3. Contact Information (REQUIRED) Email: 4a. Driver's License expiration date (REQL b. Taxicab Business Name (REQUIRED) 5. Prior experience in transportation of pa S�- vel tiL.LL"\ Cell Phone: " t("1 sent via email) 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 Deferred Suspended lead GuiltyOther 7. Have you been arrested / charged with any traffic offenses in the last five years? Tvoe 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 chauffeurs license been suspended or revoked in the last five years? Type of offense Where S Jke w4 Whe .1 1. -, La Li� Z12z:j 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) to . . 0412016 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 here y rt that I have Issued to me by the Iowa epartmefit of T anspo tiq l a,ivalid Drivers license number that If I �� ala Issued on expiring on 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 pro one Till q 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of Applloan� /F/fy Date i O --td STATE OF IOWA ) uC ^ COUNTY OF JOHNSON ) \N A� 2 COu ( 0- )q Subscribed and sworn to before me on this day of N#tMr*hN##NN*#iN*N#**##*t#k4kMMNtN#M#MNN✓M1M•M#kM###*##Mkh##*tkMNN*MN#N'**MMNRtk*YtkMM*Ni*#N**MNN#######**A**N+M#N* 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 6, Chapter 2, City Code). Explr date of Driver's license Iz �� 20 Signature of Poll es gnee 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. 1 Z Sign tura of City Cl r or designee Date N1fNtt#MttNMt#Nt*NRMMRf #ARtM*AMAM**tfR iNM**Y#1t#NR*MMRAR*i***#t**NR*NY*NHRtiMNM*tMit**tt**M1*MNMf M#NMNf ###*MNM Office Use Only Approved application DOI report State certified driving record Website update ceddrnx RN$ADQEAPPLW16tmaw#d.DOD 0412018 w ec. 10.20 0 2MUMca DCI IOWA fAVM=2.N . 6507 P. .1--"1002 STATE OF IOWA Criminal History Record Check Request Form Pap I oft —Received Time Dec. 7. 2020 9:42AM No 5819 DCI Account Number; 9967-= 11n11 S�IFJ7�S9bTlsyd l9muJQM.aoaavk7 �tityd 4 t0: Iowa DKIdon of Criminal Inv�atioa 8ot�tort Oparagom IIn»aa, I^Floor lama Ya &4Ia0 of Iowa (;sty 2If F. 70 8&*4 bees T5alnea, I0" 50319 Address P.O. Boz 428 (518) 715.6066 —+ (51� 725-080 Fax Iesra C7h, Iowa 51244 8..`�, peoaa-...... cc' • �:'� V Fax Iem-- Pap I oft —Received Time Dec. 7. 2020 9:42AM No 5819 Dec.10.2020 2:02PM DCI IOWA loft CRIMINAL HISTORY DCI 01135328 NIWEMIRaNOR CONVICTIONN ONLY PAGE 1 OF 1 DATE PRINTBD- 2020/12/10 DCI:01135326 NAME: R1R,DONINICK RICR,DOHMCK KARL DOB SEI RAC HOT HOT EYE HAIR SEN POR 19040914 M B 51D 155 BRO ELK LER NI ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y CCH RECORD ss• 01 ARRRETRD/TAKEN INTO CUSTODY 20200923 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA7D6.7(4) NARABSKM / 3RD DEO. - 1989 TRK#: 1BOD18801 COURT DISPOSITION AGENCY: IA052015J JORNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA708.7(4) HARASSNSNT - 3RD DSORES - Commamicate COURT CASE ID: 06521 SKSM112620 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#+ 180010001 SENTENCE DISP EFF DAT FINE $105.0 20200924 No. 6507 P. 2/2 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 releued to non -law enforcement agencies by the DCI. 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 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(16). Additionally, criminal history data concerning convictions for certain juvenile Sax 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 filed pursuant to Tow& Code section 232.147(10). IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION F)b( �410WA DOT wwwiowadot. ov SMARTER I SIMPLER I CUSTOMER DRIVER g Driver & Ider"vestion smicas PO Bit 92041 Des Mines, IA 503069204 Phone 515-244-91241 Fax 515239-W37 Certified Abstract of Driving Record Inquiry Date: 11/19/2020 DL/ID #: 883AL8306(IA) Customer #: 6306462 112/30/2019 Name: Rice, Dominick Earl Class: C ID Status: None Address: 2101 9th St Apt 6 Audit #: 5115190 DL Status: VAL IA Issue Date: 11/13/2020 CDL Status: None City/State: Coralville, IA Expiration Date: 09/14/2021 CDL Cert Status: None 522411536 Endorsements: NONE CDL Med Status: None Mailing Address: 2101 9th St Apt 6 Restrictions: NONE Restriction None Supplement: Date of Birth: 09/14/1984 `? 1 — _ h-•� — CD Mailing Comlviile, IA Sex: M -�:'— City/State: 522411536 History Information ca Convictions Citation Date Conviction Date ACD I Explanation lCounty Explanation JUR 112/30/2019 102/12/2020 592 Seed Johnson IA Sanctions Type Effective End ACD Explanation Occuffence JUR JUR Suspended 08/05/2020 11/03/2020 D53 Non -Payment of IA IA Iowa Fine Name: Rice, Dominick Earl DL/ID: 883AL8306 Pursuant to Iowa Code 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: Name: Rice, Dominick Earl DL/ID: 883AL8306 11/19/2020 A(5 2 �!� Driver & Identification Services Iowa Department of Transporation N C= _ ni c= —_l C:) - r ca