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Home My WebLink About21-034� r rtdf.� CITY OF IOWA CITY 410 East Washington Street Iowa City. Iowa 52240-1826 (3 19) 356-5040 (3 19) 356-5497 FAX 1. Name (REQUIRED) _ 2. Address (REQUIRED) _ IDENTIFICATION NO. 11-0514 (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 resuh in denial of the application First 3. Contact Information (REQUIRED) Email.Laµ1 (All written communis nvia email) Middle SJ_ �3 1 Phone:31 R KA I --7 s 2 S 4a. Driver's License expiration date (REQUIRED) I-1 � -202R b. Taxicab Business Name (REQUIRED) 9 l "Tire, -7--�) 5. Prior experience in transportation of passengers: 1 a W A CI-t� 6g �� 1 L (Z 11 fkIZS L 1 it, a -Np-1 V a CZ- Z NC -A -F S 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this State et Type of offense Where 70 '—d What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended Plead Guil Other 7. Have you been arrested / charged with any traffic offenses in the last five years? 0 S Type of offense Where When Co. `7 2 —/R What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended ) Plead Guil 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 youever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) A O 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 REVIE 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 7SA Ate(, I Issued on iO-z l 2000 falsely answer any questlons In this application, that this application may berdenied.l I ag�ee hatpin makI understand that If I ing this applicationecords , I on consent to allow agents or employees of the City of Iowa City, Iowa, In their discretion, to —examine any and all application I documents relating to this application, and I further agree that, If authorization to be a taxicab driver a granted, al comply at all times with all of the provisions of Title 6, Chapter t City Code. (Needs to be signed In front of a Notary Public) Signature of Applicant t Date -zq.z -- n-m,ef#%#f%k#f}#f#A#Y%#!%##%Y#M%%##f%%%#f1f%fffy#f#%.µ 4Y1f#}MM##Y#iMY#Y}}#fY NYN%#1# STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed answorn to before me by o, ;�Q � r J"uLv an lbw� c-' of Notary Public In an or tcY� n ete MY Ma, I have reviewed this application, DCI report, and the State certified driving record of this applicant dents of the City of Iowa City (Title 6, Chapter 2, City Code). and have dWrmirred that there is no information which would Indicate that the Issuance would be detrimental to the safety, health or welfare of resi- txpiration date of Driver's license. 5 grSalur 5 e ofCdesignee 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. 7 zl Date Approved application Office Use Only DCI report State certified driving record Website update cwwrnxi NSWGe�Mlft �d.Doc 04/2010 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). hereby certify that I have issued to me by the Iowa Department of Transportation a valid Driver's license number i7 I issued on i0'Z 120? expiring on 11 l 6 ZO 28 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 1 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, f the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant 1 Date Z I y i� ►=►� STATE OF IOWA COUNTY OF JOHNSON Cr1 Subscribed and sworn to before me by Dao/ cQ KitrjvI on thisv ( day of �711ALA.r 70 3L 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 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 x,++xxxx,„xxx,+x+x+xxxxx+x+x+xx+xxx,+„+++xxxx,„„++xxxxxxx,++xxxxxxx„x++xxx,xxx„x+xxxxxx,++xxxxxxx,,,xxxxx,xxx,r+xxxxx++x++++axxxxxxx++x+++ Office Use Only Approved application DCI report State certified driving record Website update oeddraxiM1VBADGe PPLezoieemended.Doc 04/2018 Jul. 7.2021 8:54AM DCI IOWA No.3768 P. 1/4 JUL/01/2021/TRU 02101 PM FAX INC, P. 002/002 FAX STATE OF IOWA =. I I'i i'i' a, History y R'.1'A Check Request FormA. �3 a To: Iowa Division of (Aminal Investigation Support Operations Bureau, 1" Floor 1-15 E. 7"' Street Des Moines, Iowa 50319 (515)725-6066 (515)725-6080 Fey I stn renuectina an Iowa a-iminal History Record Check on: ACI Account Number. (1=>-f (f ap�aebla) 0 From: (Sty of Iowa mt1 City Clerk's Q!Ud 410 E. Washill" Stk& Iowa City, IA�f£4e Phoste: 3I9 -35&504E --j; _ ►`""1 Fal: 319-356-549a CA LU Name (mandate ) Mrst Name (mandatory) Middle Name r c*=w d S -r-2 L C— (Z— Date of Hirth (mandatory) Gender (m.na Social *Uft Number (reeomtnonded) ®Female_ j Waiver Information. Without a signed waiver troot the subject of the request, a complete criminal history record may not be relenabie, per Code of Iowa, Chapter 692.1. For colipplete criminal history record information, as allowed by law, always obtain a waiver signature from the subject of the request. Waiver Refarae: I bsnby got prnniallon fm the above requa511ng official to conduct an Iowa criminal bhtory record cheek wilt the Division of Criminal Invaggatioo (DCD, Any criminal hisbry data oonceming me that is maintained by the DCl ay be released as allowed by law. Waiver Signatrrr As of _� �� a search of the provided name and date of birtkl revealed; ® No Iowa Criminal History Record found with DCI E. Iowa Criminal History Record attached, DCI # �) ` :� 31 DCl initials"'_ DCI -77 (08/25/10) Received Time Jul. 1. 2021 1:35PM No,3265 Jul. 7, 2021 8:54AM DCI IOWA IOWA CRIMINAL HISTORY MISDEMEANOR CONVICTIONS ONLY No.3768 P. 2/4 DCI 00312314 PAGE 1 OF 3 DATE PRINTED - 2021/07/07 DCI:00312314 NAME: NETZLER,DAVE METZLER,DAVID MILTON DOB SEX RAC HGT WGT EYE HAIR SKN POB 19581116 M W 600 150 HAZ SDY MED IA ADDITIONAL IDENTIFIERS DISP EFF DAT 19831126 19831126 19831126 19831126 DISP EFF DAT 19890628 19890628 CCH RECORD •*• 01 ARRESTED/TAKEN INTO CUSTODY 19631126 AGENCY: IA0570DOO LINN CO SO CHARGE NO- 01 IA STATUTE IA321-281 OPER WHILE INTOX TRK#: L25116101 COURT DISPOSITION '-1 C -S f" <m AGENCY: IA057015J LINN CO DIST COURT COUNT NO- 01 IA STATUTE: IA321-281 OMVUI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L25116101 D SENTENCE FINE $300 PRORATION 6HRS CRED-PROB TIL 020885 SUSPENDED 2D CREDIT W/TIME SERVED 02 ARRESTED/TAKEN INTO CUSTODY 19890405 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE XA321J-2 OWI 2ND TRK#: L25116201 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J-2 OWI 2ND CHARGE CLASS: MISDEMBANOR CONVICTION TRK#: L25116201 SENTENCE JAIL 10D CREDIT 7 HRS/PAY SURCRG FINE $750 03 ARRESTED/TAKEN INTO CUSTODY 19940807 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA321J-2 OWI 2ND TRK#: 006445901 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J-2 DISP EFF DAT 19831126 19831126 19831126 19831126 DISP EFF DAT 19890628 19890628 O '-1 C -S f" <m C1 a rn D CJ7 N Jul. /. ZVII d:)7AM uci 1VWA No. 3168 P. 3/4 OWI 2ND N CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 006445901 SENTENCE JAIL 15D FINE $750 PROBATION lY SUSPENDED 35D D PAY SURCHG 04 ARRESTED/TAKEN INTO CUSTODY 19981125 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA709-4 SEXUAL ABUSE 3RD DEGREE TRK#: 032253001 COURT DISPOSITION AGENCY: IA0520150r COUNT NO- 01 JOHNSON CO DIST COURT IA STATUTE: IA 709-11 ASSLT W/INTENT COMMITT SEX ABUSE NO INJURY CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 032253001 RESTITUTION DCI 00312314 PAGE 2 OF 3 DISP EFF DAT 19940928 19940928 19940928 1994092B SENTENCE DISP EFF DAT PLEAD GUILTY 19990526 FINE $500 19990526 PROBATION 2Y 19990526 SUSPENDED 2Y 19990526 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 DCT. N e 9 D ge CD c.n N 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 DCT. Ju 1. /. 2U21 U:55AM DCI IOWA No. 3768 P. 4/4 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 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.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). 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. %v DIVISION OF CRIMINAL INVESTIGATION C:) r, rn xm ti CA 10WA00T www.iowadotgov SMARTER I SIMPLER I CUSTOMER DRIVEN Driver & IExNLfeation Smiors Pd Box 92041 Des Mine& IA 5040&9204 Phone -5115-244-9124 1 Fax 515-2991837 Certified Abstract of Driving Record Inquiry Date: 6/29/2021 DL/ID #: 075AA1861(IA) Name: Metzler, David Class: D CDL Med Statud`a?'9Jone— Milton 3ohnson IA Address: 310 N GEORGE ST Audit #: 5058470 r -n Issue Date: 10/21/2020 City/State: NORTH LIBERTY, IA Expiration Date: 11/16/2028 523179671 Endorsements: Chauffeur 3 Mailing Address: 310 N GEORGE ST Restrictions: NONE Date of Birth: 11/16/1958 Mailing NORTH LIBERTY, IA Sex: M City/State: 523179671 History Information Convictions Customer #: 1984143 ID Status: None DL Status: VAL Conviction Date rro CDL Status: Nonce Explanation E.7 ]UR CDL Cert State _Mlonj—, -1-1 CDL Med Statud`a?'9Jone— t--- 3ohnson IA Restriction one Supplement: � , r -r»�I� r^ # r -n 'v Citation Date Conviction Date ACD Explanation County ]UR 07/16/2019 07/23/2019 S92 Speed (10 mph & 3ohnson IA under in 35-55 mph zone Name: Metzler, David Milton DL/,{D: 075AA1861 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 causgdmy signature and the seal of the Department to be set upon this document, at Ankeny, Iowa this date: {ca !' �Qpa,��,iNt Oc F�4M9O� e k \ II Name: Metzler, David Milton Dl/ID: 075AA1861 6/29/2021 01112 Driver @ Identification Services Iowa Department of Transporation C"' O eXl