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HomeMy WebLinkAbout21-005CITY OF IOWA CITY 410 East Washington Street IOn'a City. lorca 52 240-1 82 6 13191356-5040 13191 356-5497 FAX U t IDENTIFICATION NO. (Office Use Only) JAN 2 5 M1 APP&;A46N FOR TAXICAB / MOTORIZED PEDICAB VEHICLE DRIVER (Police b aitmentrevUw must be made between 8 a.m. to 3 P.m., Monday - Friday) Failure to complete the "required" Information will result in denlai of the application Last First Middle 1. Name(REQUiRED) StrOrn� PC,., ( C 2 Address (REQUIRED) 2✓203 / /12 if, r cI ,- S iA 5 1 X41 i 3. Contact Information (REQUIRED) Email: A-/ i P/074,j ei!-7 Cell Phone: L0/- i/V ' 93 W, (All written communication sent via email) 4a. Driver's License expiration date (REQUIRED) 7 13 02-4 b. Taxicab Business Name (REQUIRED) Lt ad ✓ '-u k) 5. Prior experience in transportation of passengers: /V14 6. Have you ever been arrested /charged with any misdemeanors and/or felonies in this State or elsewhere? �— Tvne of offense W here When .z o What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended Plead Guilty Have you been arrested / charged with any traffic offenses In the last five years? TVD@ of offense What happened to the charge? (Circle one) Where Other rtrf /r�'1i Convicted Dismissed Deferred Suspended lead Gui 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) (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) 04/2018 Paget FILED APPLICATION FOR TAXICAB VEHICLE DRIVER DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERTIFIED DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF REVIEW JAN 2 5 2711 You must apply for an Individual Department of Criminal Investigation Report (form avallabl"09rijA Wist), City, Iowa I hereby certify that I have issued to me by the Iowa. Department of Transportation a valid Drivers license number `i X f� 2 �� Issued on � expiring on 1131 / 2 7 . I understand that if 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 PU Date A-12,0:? ffHtfffftl1N4N1ff fNNllffNf f 1fNflffNlff ffff tMffyif If 41f 1Lfflfif k4fNlNfflif R1t1ff NNf f f fN1Nf YfNMfi4fYlNRfifllff NfRNNNNiOIfNt STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and swum to before me by on this day of Notary Public in and for the State of Iowa f1M}kR1 R1iMiffNltlfffN}Rikf 41f4iRRNkh 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 1131 / ZG Z1 Signature of Police Chief or designee 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. _ of - 0,I_z;- �:1-0a--I Data Approved application Office Use Only DCI report State certified driving record Website update CIeM/WOnNBADGEIPPL929I81.111.DOG 04 018 oU�an.19.2D21�. 1.31PNi� DCI IOWA f�I93iliNo_M5 P. 1/3e I STATE OF 10W.AF *1 , Crimfnal Ei�tory Record Cbeck Request Form JAN 2 5 Y r a.41Y Clerk r Uwe OFemal� 8�.G1U g1B. '' ' weora my "+, ..S�V.` Fes: ��•'��1,:f, Record Check)Res As of \V1 a eomnh of$e pr014 d asme',7,•# Y1 ••. s aad date of bhth revs a ,n ©n r i NoLmUbak4 M" Rmord found with DQ tIowa xeoord at lzod DCI # q °61 " •t. } F n-1. DCr s� ��� n DCZ.77 (may 06" a rReceived' Time Jan. 13. 2021 10:24AM Ko -0172 lo)0 Citj, IgWa DCIAccmtNmuwrt 9pm.. g 31q; gig~ ^ Iuwa DhUiou of C?imioal IeveatigaIDa S%Vo 't Opemtio,,, Rnreaa, l■ Floor Name Ye06w ('.ab of fovea ZIS X. 7% 6Roe< Dap(SM774.6166 10319 Addrwa P.O. Ror 428 (515) 725-6050 Iran Tow- City, Iowa M" 2 , . Phone _ 19 738-9777 par 319,3591162 ti — r Uwe OFemal� 8�.G1U g1B. '' ' weora my "+, ..S�V.` Fes: ��•'��1,:f, Record Check)Res As of \V1 a eomnh of$e pr014 d asme',7,•# Y1 ••. s aad date of bhth revs a ,n ©n r i NoLmUbak4 M" Rmord found with DQ tIowa xeoord at lzod DCI # q °61 " •t. } F n-1. DCr s� ��� n DCZ.77 (may 06" a rReceived' Time Jan. 13. 2021 10:24AM Ko -0172 Jan.19.2021 1:31FM DCI IOWA N0.0765 P. 2/3 IOWA CRIMINAL HISTORY DCI 00978909 MISDEMEANOR CONVICTIONS ONLY PAGE I OF 2 DATE PRINTED - 2021/01/19 DCI:00978909 NAME: HTROUD,PAUL EUGENE DOH SEE RAC HGT WGT EYE HAIR SKN POB 19770731 M. w 601 300 BLU GRY LOT IA ADDITIONAL IDENTIFIERS PHOTO AVAILABLE! Y CCH RECORD ••• : I-- 01 ARRESTED/TAKEN INTO CUSTODY 20130409 AGENCY. IA0570000 LINN CO SO CHARGE NO- 01 IA STATUTE IA321J.2(2)(A) JAN 2 5 2021 OPERATING WHILE UNDER THE INFLUENCE 1 TRK#: 5Ao0JW9Cl City Clerk COURT DISPOSITION Iowa City, Iowa AGENCY: lAO57015J LINN CO DIST COURT COUNT NO- 01 IA STATUTE: IA321,7.2(2)(A) OPERATING WHILE UNDER THE INFLUENCE INT OFFENSE COURT CASE ID: 06571 OWCR1U3211 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: SA00JW901 DRUNK DRIVING SCHOOL SENTENCE DISP EFF DAT TIME SERVED 20130627 JAIL 48H 20130627 MAY COMPLETE OWI WEEKEND IN LIEU OF JAIL FINE $1250 20130627 MAY NAIVE $625.00 OF FINE UPON PROOF OF INTERLOCK An arrest without disposition is not an indication of guilt. This record maintained by the Iowa Division Of Criminal Investigation, Bureau Of Identification is a public record but can only be released to non -law enforcement agencies by the DCI. This reeoonae can only include public criminal history data. Under Iowa law, most juvenile records are confidential. Confidential juvenile court records, if any, cannot be Included in this response. A signed release authorization is not sufficient to obtain this information from the Division of Criminal Investigation. In order to request the release of confidential juvenile records, if any, an application must be filed pursuant to Iowa Code section 232.147(18). Additionally, criminal history data concerning convictions for certain juvenile sex offenses can be found on the Iowa Sex Offender Registry: http://www,iowasaxoffender.com/ . However, even though some Information is available on this site, the actual records for juveniles may still be confidential and any confidential juvenile records cannot be provided with this record. In order to request the release of confidential juvenile records, if any, an application must be filed pursuant to Iowa Code section 232.147(18). Jan.19.2021 1:32PM DCI IOWA No.07B5 P. 3/3 IN THC ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION 0) JAN 2 5 2021 City Clerk Iowa City, Iowa 0 C10WA DOT ,Nww.i Wi3 SMARTER I SIMPLER I CUSTOMER DRIVEN 0 CIO g0 Driver i Id$RWWJNorl saurus PO Bos 92M 1 Des Moines, IA 59986 WW Phone 515-24"1241 Fax 515299-1837 Certified Abstract of Driving Record Inquiry Date: 1/11/2021 DL/ID #: 431XX6624(IA) Name: Stroud, Paul Eugene Class: C Address: 3203 Blackberry Cir Audit #: 3903335 CDL Cert Status: SW Iowa Fine CDL Med Status: None Issue Date: 06/08/2019 City/State: Cedar Rappids, IA Expiration Date: 07/31/2027 524D42560 Suspended, Denied, Endorsements: NONE Mailing Address: 3203 Blackberry Cir Restrictions: Corrective Lenses 06/05/2015 SW B20 Driving While Cedar IA Date of Birth: 07/31/1977 Mailing Cedar Rapids, IA Sex: M City/State: 524042560 Cancelled Revoked History Information Convictions Customer #: 2295560 ACD ID Status: VAL JUR DL Status: VAL A20 CDL Status: None IA CDL Cert Status: None Iowa Fine CDL Med Status: None Restriction None 020 Supplement: Clinton _ Suspended, Denied, JAN 2 5 1021 City Clerk Iowa CitY, Iowa Citation Date Conviction Date ACD Explanation County JUR 04/09/2013 06/27/2013 A20 Operating While Linn IA Iowa Fine Intoxicated 03/24/2015 04/07/2015 020 Driving While Clinton 1A Suspended, Denied, Cancelled Revoked 06/05/2015 06/17/2015 B20 Driving While Cedar IA Suspended, Denied, Cancelled Revoked 11 23 2018 1,/../201. B64 i No Insurance Card lJohnson IIA Operating While Intoxicated Test Refusal/Test Failure Violations Occurance I ACD Explanation JUR iCountv 04 09 2013 Al2 OWI Test Refusal IA Unn Sanctions Type Effective End ACD Explanation Occurrence JUR JUR Revoked 04/20/2013 04/19/2014 Al2 OWI Test Refusal IA IA Suspended 08/04/2014 08/07/2014 D53 Non -Payment of IA IA Iowa Fine Suspended 11/26/2014 03/27/2015 863 Fall to Refile IA IA SR22 Suspended 05/12/2015 05/10/2016 D27 Violation of IA IA Probation Barred 07/22/2015 07/20/2018 W01 Habitual IA IA Offender Suspended 08/30/2015 05/11/2017 B63 Fail to Refile IA IA SR22 Suspended 05/11/2016 05/09/2017 B26 Driving While IA IA Suspended, Denied, Cancelled, Revoked Name: Stroud, Paul Eugene DL/ID: 431XX6624 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 An4ily, Iowa -, this date: JAN 2 5 2021 Name: Stroud, Paul Eugene DL/ID: 431XX6624 1/11/2021 A2zk�� Driver & Identification Services Iowa Department of Transporatlon