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Home My WebLink About21-014„ �yyltmr�1l CITY OF IOWA CITY 410 East Washington Streel Iowa City. Iota 52240.1826 (3191356-5040 (319) 356-5497 FAX 1. Name (REQUIRED) _ 2. Address (REQUIRED) IDENTIFICATION NO. Z � - ')Y `A (Office Use Only) APPLICATION FOR TAXICAB I 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 3. Contact Information (REQUIRED) Email: 4a. Driver's License expiration date (REQUIRED) _ b. Taxicab Business Name (REQUIRED) Yi 1 IC 5. Prior experience in transportation of passengers: 9 O y� Middle " I)- TtO 't 54—Illu l;at� VA ]IN been arrested / charged with any misdemeanors and/or felonies in this State or elsewhere?� S i What happened to the charge? (Circle one) Ndo GoP,4AAriP, Convicted Dismissed Deferred Suspended Plead Guilty Othe �M fe�p I 7. Have you been arrested / charged with any traffic offenses In the last five years? k o I 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? No t 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) NO / (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) 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 e� c�r fy that G hie issued to me by the Iowa D pa ment of ringTraon ortQati n a I'd Driver's understand that If I �� 7'2 ) Issued on O Zr ! i expiring on falsely answer any questions In this appllcation, that this application may be denied. I a ree at in making this application, 1 consent to allow agents questions 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 �U�G ��L� Dam D �6 2c�x1, f4ff!##f f#Y#####!}Nf #ffflf##KNIT#NK#K###!###KK###'}ffK#1#!HK#Ni###NkkR/#fK#Nf#ffN!#f##NNNNfNfKKNK#NK#K1#K##Y##N!#fI' STATE OF IOWA ) COUNTY OF JOHNSON ) on this day of Subscribed and sworn to before me by K#,fKKN.KKfNK..KK#+Kf*K•#• 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 Zb _ 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. or Office Use Only Approved application DCI report State certified driving record Website update 03-1—i-Zt Date OWTAXIDPWADGEAPPL92018amandad DOC 0412018 Mar.15.2021 10:16AM DCI IOWA No.8078 P. 10/11 03112/2021 10,§0 YBIroWCob fA*3193382roa r.uua+u03 FAX STATE OF IOWA Criminal, Mstory Reeord Check Request Form DCI mcountNumber: 9967-F Gtapp9erbte) Mail or FOX campleM forms to; Send results triY Iowa Division of Criminal Investigation Name 'YelldwAab of Iowa CiLV SnpPOrt Opera{IONBw'aAW I`F1oor 215 0. r st met Address P.O. Sox 428 Des Moines, Iowa 50319 • (51S) 725.6066 Iowa City,'Iowa SZ244 (515) 72S ND Pax Phone (379)338-9777, Fax 879.354.6142 e l' :1. T3, a: a l.: l '�rtT ! 6 ar'x:11 v +`�:Lsf�?�'>'"`.yA>.s ??.'v'. ic,, yi'Rt:, : r•r.�„ I y .e 'e. t-.. •�.!(I_�, ,..� . II a .Y li I� i✓��sa %xliY`N f e�-�",n�'�S .y9'�p 11 +} ) 1 x r �i. ,.Se. e e• -,F� r - �e 9 � r �� 1 `ry,��,•�.yz•� ! ap i.''` / Yi tic X ,1' e r{�4°?,:� ,��r�.L:��"4•:4 I. - Yt` e ':. p T Itis 1 CISJi , wafinal Kbtory Record C ® `�,, locreaee,y. a�,o .........,• � w As of d a search ofthe provide tx 9nd dais ofliir a alod: a nr . 'z_ op (•lou-$ r.rlrnin4! NoIowaedmin iMatoryRoi ordfouui�v�ii b$ dV".'✓ re5Lats: a u •� 0 OC ❑ Iowa Cominal History Record attached, n�,,�"a ~ p roo h Co �ii�iiq.��Ri11nIrtRnP'leol`l� � DCiinitials V i o DCI -77 (vdined 06-26.2018) Pup r of 2 -Received Time Mar. 17. 9021 10:12AM No, 7921 Mar.15.2021 10:17AM DCI IOWA DISCLAIMER No. 8078 P. 11/11 This response can onlyinclude public criminal history date. Underlowa 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 confrdentlal juvenile records, If any, an application must be filed pursuant to Iowa Code section 232.147(98). Additionally, criminal history data concerning convictions for certain Juvenile sex offenses can be found on the Iowa Sex Offender Registry: httn://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 confidentlal juvenile records, If any, an application must be filed pursuant to Iowa Code section 232.147(18). 40'"ioWADOT SMARTER I SIMPLER I [USTOMER DRIVEN www.lowadotgov Drber A Idw9ftaWn Sales PO Box 92041 Des Mcirx IA 50306-9M Phone 510;-244-9124[ Fax 515239-11837 Certified Abstract of Driving Record Inquiry Date: 3/12/2021 DL/ID #: 250AP5873(IA) Customer #: 6727356 Name: Carr, Marius William Class: D ID Status: None Address: 905 W BENTON ST Audit #: 4928804 DL Status: VAL APT 13 Issue Date: 09/02/2020 CDL Status: None City/State: IOWA CITY IA Expiration Date: 04/20/2026 CDL Cert Status: None 52246593 Endorsements: Chauffeur 2, CDL Med Status: None Motorcycle Mailing Address: 905 W BENTON ST Restrictions: NONE Restriction None APT 13 Supplement: Date of Birth: 04/20/1954 Mailing IOWA CITY, IA Sex: M City State: 522465935 History Information CLEAR DRIVING RECORD Name: Carr, Marius William DL/ID: 250AP5873 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 this date: Name: Carr, Marius William DL/ID: 250AP5873 3/12/2021 C� Driver & Identification Services Iowa Department of Transporation