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CITY OF IOWA CITY
410 East washin5ton Slreel
lon•x City, Iowa 52240-1826
(319)356-5040
(319)356-5497 FAX
1. Name (REQUIRED)
2. Address (REQUIRED
3. Contact Information (REQUIRED) Email: LLf 4 95r '(n `oJ ,(s M Cell Phone:.3%36
(All written communicatio sent via email)
IDENTIFICATION NO. J � -- (;
(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 mtreii . 4b"M d'fthe apptic2tic ;.
Last First JAN Middle
4a. Driver's License expiration date (REQUIRED)
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? Ajo
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? 1�0
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 chauffeur's license been suspended or revoked In the last five years? /Jp
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 2011
DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF RORT AND STATE EVIEW JAN $
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 Issued ora De11artmeLV ct of xpiringnonorr2d10 ;UZon a j lid Ddver's license number
unde stand that If I
PP y g this a Ilcation, I
falsTellyy answer any questions In this application, that this a licatbn ma be denied. I agree that In making pP
consent to allow agents or employees of the City of ree that, If authorization Iowa City, Iowa, in their discretion, to examine any and all records and
tdocumentsimes with all offthe provisions of Title 5, Chapter 2, oto this apication, and I further f the City Code. (Needs too be signed in fr nt of Notaryabe a taxicab driver is rPublianted, to c) at all
Signature of Applicant
A,Qps Date 0 a
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STATE OF IOWA )
COUNTY OF JOHNSON )
on this day of
Subscribed and sworn to before me by
Notary Public in and for the State of Iowa
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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 Z-0 - ZI
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 THEDATE LISTED BELOW.
Office Use Only
Approved application
DCI report
State certified driving record
Website update
Date
Cl.&n MIDRIVBADGEAPPL920IBameMMDOC 0412018
J10WAD0T www.iowadot.gov
SMARTER I SIMPLER I CUSTOMER DRIVEN g
DrNN a ld"a fitanon unkli s
PO Box 92041 Des Manes, IA 503069204
Phone 515-244-9174 1 Fax 5 15239-1837
Certified Abstract of Driving Record
Inquiry Date:
1/5/2021
DL/ID #:
479AS5393 (IA)
Customer #:
7035183
Name:
Tuhairwe, Ronald
Class:
A
ID Status:
None
Address:
1809 Grantwood Dr
Audit #:
4888336
DL Status:
VAL
Mailing
Iowa City IA
Issue Date:
08/18/2020
CDL Status:
VAL
City/State:
Iowa City ]A
Expiration Date:
12/10/2021
CDL Cert Status:
Excepted Interstate
522405999
Endorsements: NONE
Mailing Address:
1809 Grantwood Dr
Restrictions: Automatic
Transmission, No
Manual
Transmission
Equipped CMV
Date of Birth: 03/14/1991
Mailing
Iowa City IA
Sex: M
City/State:
52240599
History Information
CLEAR DRIVING RECORD
Name: Tuhairwe, Ronald DL/ID: 479AS5393
CDL Med Status: None
Restriction None
Supplement:
Pursuant to Iowa Code 4321.10, 1, 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: Tuhairwe, Ronald DL/ID: 479AS5393
1/5/2021
c�
Driver & Identification Services
Iowa Department of Transporation
JAN 8 2021
City Clerk
Iowa City, Iowa
G1JUWav:;Z621 1:r,wwvl19PM DCI IOWA fA>1�1957laNw92�� F J021002
STATE OF IOWA
Criminal History Record Check
Request Form
Ma or Fax eomnleted fotnu to:
Uwa Divietoo of Criminal Invordliadoo
Support Oporatloat Burson, 1^ Floor
215 K r Street
Des tKoises, Iowa 50319
(515)725-6066
(515)725-6080 Fax
I am rem:aainr an Iowa Crirtirtal :Iistory Record
DCI Account Number: 9967-F
Send rcxi:lw W;
Nome Ycllew,C.l) of lows Cl
Address P.O. Boz 428
lows C , ls.w 52340
Plooae (319) 3349777
Fax 319-35911142
015'LIIMi I ¢JMale Female I -n C-31 —;,9OZ 1
As of a ecarch of the provided n*c aqd date'o?left "yc
t3 •.
4 P
No Iowa Criminal History Record found with1? ren
sec-
ID
Iowa Criminal Hittory Record attached, DCI 0
DCI fidwila k- _
DCI -77 (updated 06-26-20113)
Received Time Jan. 4. 7021 11:10AM No.8964
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JAN 8 2021
Jan. 5.1021 2:19PM DCI IOWA ND.9270 P. 2
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 juvenite 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:
htta://vvww.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 Iowa Code
section 232.147(18).
JAN 8 2021