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Home My WebLink About21-040� r NNE CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX 1. Name (REQUIRED) _ IDENTIFICATION NO Zi -oya (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 -vhtrne�s�e< T,m 2. Address (REQUIRED) 7o10 Middle Wi)I,aV%4 3. Contact Information (REQUIRED) Email: t'm wHfMf15)��atrc° Coy"' Cell Phone: (All written communication sent via email) % 4a. Drivers License expiration date (REQUIRED) V / ` o ` 019 b. Taxicab Business Name (REQUIRED) i/ e. I10 W 5. Prior experience in transportation of passengers: 2 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere?e�� Type of offense Where What happened to the charge? (Circle one) Convicted Dismissed Deferred SuspendedPlead Guilty' Other _ 7. Have you been arrested/ charged with any traffic offenses in the last five years? NO Type of offense What happened to the charge? (Circle one) Where When 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? N 0 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) N0 (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) 04/2018 R 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 hereby certifyTat I have issued to me by the Iowa Department of Transportation a valid Driver's license number :It jcx )49{ issued on.expiring on ViS�_. I understand that if I falsely answer any que tions in this application, that this app kation 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, C apter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant VW� w Date $ t9 1 1 2' Yfffi-1X#X#llffffX*#X#1*ilfe###fHfHffHllfHfffHHHfIfH1HHH11fff1fff1HH11ffffllfXHXlf#+ffffff#1t1#!#fflfXHfflffffilfX# Y�Ai-f t1fTf STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by T e, n°t % _Ua) � r avt AAJA (wt,fi"j—this l Ct day of 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.vyelfare of resi- dents of the City of Iowa City (Title 5, Chapter 2, City Code). Expiration date of Driver's license ✓T�e9 2�/ Zo2/ Sig6ature 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 THE DATE LISTED BELOW. Office Use Only Approved application DCI report State certified driving record Website update Date C1wkNM1DRNBADGEAPPL9201Bam nd d.DOC 04/2018 r 07108: 3. 2021..12:,43Pt Cob DCI IOWA ¢A>n919999iNo. 8049 P• • P.3021002 FAX STATE OF IOWA Cirtmi"O History Record Check Request J'orw I DO A.Cootmt Number: 9967-F 9 eted tp• Rappl MWO) Io )XVidon of Crt n 16 Nott Operations )3ztrmi4 ?� S. 715 Street Nttme YOUw:C it of lora 14 Inoor Ds� I4lnfine16 Iowa. $0319 Address P.O: Boz 428 726-6066 C�}� 735 6080 Town FaY atg, Iowa 52244' IRW% X41 iiiatory F=Ord found with DCI Phone (3191338-9T17 rami pax 319,459-4142 sn Iowa Crimivaj,gi5to Record Cbeck o .. . �yl� ryon: . a ,"OtIAy uliil�aM . fiord attache DCI* „�, �• �- ccci .. .. . DC7 inffials� s ia&U4 '; Received Time Jul, 27. 2021 3:23PM No. 7063 beck Resui As of ° a 00"r l ofthe yrowided ne=e and date of birthNo W. IRW% X41 iiiatory F=Ord found with DCI C� C° 01 l Iowa az'19 fiord attache DCI* „�, �• �- ccci DC7 inffials� y o DCI -77' Cak��'06=26.20T8) . r PqQ I oft '; Received Time Jul, 27. 2021 3:23PM No. 7063 r Aug. 3.2021 12:44PM DCI IOWA IOWA CRIMINAL HISTORY MISDEMEANOR CONVICTIONS ONLY DCI:00373688 NAME: FUHRMEISTER,TIM FUHRMEISTER,TIMOTHY WILLIAM FURHMEISTER,TIM FURHMEISTER,TINOTHY WILLIAM DOB SEX RAC HOT WGT 19650818 M W 600 200 ADDITIONAL IDENTIFIERS TAT L ARM TAT L CALF TAT L LEG DCI 00373688 PAGE 1 OF 3 DATE PRINTED - 2021/00/03 EYE HAIR SXN POB BLU BRO FAR IA CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 19080403 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA122-46 PUBLIC INTOX TRX#: L32958601 COURT DISPOSITION AGRNCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA123.46 CONSIIMPTION / INTOXICATION - 1970 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L33958601 SENTENCE PLEAD GUILTY FINE $25 COURT COSTS $20 02 ARRESTED/TAKEN INTO CUSTODY 19900401 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE TA204-401-3 POSSESSION.SCHEDULE I/MARIJUANA TRK#: L33958701 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA204-401-3 POSSESS SCHEDULE I/MARIJUANA CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L33958701 SENTENCE JAIL 1D CREDIT W/TIME SERVED 8H 03 ARRESTED/TAKEN INTO CUSTODY 19971005 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA700-2A-2B ASSAULT/CAUSE INJURY/DOMESTIC TRK#: 037285101 DISP EFF DAT 19880418 19880418 19880418 DISP EFF DAT 19900703 19900703 No. 8049 P. 2 Ci — — C C: 3 �v cn Aug. 3.2021 12:44PM DCI IOWA No. 6049 P. 3 COURT DISPOSITION AGENCY: IA052015J COUNT NO- 01 JOHNSON CO DIST COURT IA STATUTE: IA236-2-2 DOMESTIC ASSAULT CAUSING INJURY COURT CASE ID: 06521 SRCRD45754 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 037285101 SENTENCE SUSPENDED JAIL 28D JAIL 30D FINE $250 PROBATION lY DCI 00373688 PAGE 2 OF 3 DISP EFF DAT 19980115 19980115 19980115 19980115 04 ARRESTED/TAKEN INTO CUSTODY 19961104 AGENCY! TA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA708-2A(2B)(3B) ASSAULT WITH INJURY/DOMESTIC/ENHANCED TRK#! 044597001 COURT DISPOSiTTON AGENCY: IA05201SU JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA708-2 ASSAULT CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 044597001 SENTENCE DISP EFF DAT JAIL 1D 19990223 An arrest without disposition is not an indication of guilt. This record: C-; maintained by the Iowa Division Of Criminal Investigation, Bureau Of - Identification ie a public record but can only be released to non -law enforcement agencies by the DC1. :71 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 Bite, 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 (`r section 232.147(18). � x C + N O r_. X. tiJ N CO ✓ Aug. 3.2021 12:44PM DCI IOWA No.8049 P. 4 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 ✓_ O �r rn N 07&g.3.2021,12;43&6 DCI IOWA ! 1�r !FAM19SM2,o. 8049 P. , ,,)02r002 STATE of Iowa F ' Cd incl H98t0x y Record Check Request Porn, a btvision of Comtnsl h'Testigati. Pott Operations lbrean, In Ploor E. 7M Street Maes, Iawa 50319 9725-6066 )'5-6080' Ira DCI -77 DC 1 Ac Mt Number;. 9967-F s 9emrh ofthe Providod name and data No Iowa criminal "'Otory Record fbzd with DCI Iowa Crjm : 147mry Xomrd attache bCi # DCI iniHals�., . 15 ?--Recei.ved Time Jul, 21' 2021 3:23PM No. 7063 _.-- ,.�.,e�� ;9k:glIdivad:by:law, y ��, pf ,�EOea atdOdo • •1' Y 1 iw psgjJF� ` . ? Pqe 1 ON cita�ruw�ae� . Name XeIlowotlopva Address P.O.S a4U lova c Iona =m Phone 3 3g pox 9193591142 s 9emrh ofthe Providod name and data No Iowa criminal "'Otory Record fbzd with DCI Iowa Crjm : 147mry Xomrd attache bCi # DCI iniHals�., . 15 ?--Recei.ved Time Jul, 21' 2021 3:23PM No. 7063 _.-- ,.�.,e�� ;9k:glIdivad:by:law, y ��, pf ,�EOea atdOdo • •1' Y 1 iw psgjJF� ` . ? Pqe 1 ON Aug. 3.2021 12:44N )CI :OSA IOWA CRIMINAL HISTORY MISDEMEANOR CONVICTIONS ONLY DCI:00373688 NAME: FUHRMSISTER,TIM FUHRMEISTER,TIMOTHY WILLIAM FUAHMEISTER,TIM FUREMEISTER,TINOTHY WILLIAM DOB SEX RAC HOT WGT 19680818 M W 600 200 ADDITIONAL IDENTIFIERS TAT L ARM TAT L CALF TAT L LEG DCI 00373668 PAGE 1 OF 3 DATE PRINTED- 2D21/OB/03 EYE HAIR SXN POB BLU BRO FAR IA CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 19080403 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA123-46 PUBLIC INTOX TRX#: L33958601 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA123.46 CONSUMPTION / INTOXICATION - 1970 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L33958601 SENTENCE PLEAD GUILTY FINE $25 COURT COSTS $20 02 ARRESTED/TAKEN INTO CUSTODY 19900401 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA204-401-3 POSSESSION.SCHNDULB I/MARIJUANA TRK#: L33958701 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA204-401-3 POSSESS SCHEDULE I/MARIJUANA CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L33958701 SENTENCE JAIL 1D CREDIT W/TIME SERVED 8H 03 ARRESTED/TAKEN INTO CUSTODY 19971005 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA708-2A-2B ASSAULT/CAUSE INJURY/DOMESTIC TRK#: 037265101 DISP EFF DAT 19880418 19980418 19880418 DISP EFF DAT 19900703 19900703 No.6049 P. 2 ti 0 ....+ "� ^ �7 n C7 r Q Y _ 2> .. fV CO Aug. 3.2021 12:44PM DCI IOWA No.8049 P. 3 COURT DISPOSITION AGENCY: IA052015J COUNT NO— 01 JOHNSON CO DIST COURT IA STATUTE: IA236-2-2 DOMESTIC ASSAULT CAUSING INJURY COURT CASE ID: 06521 SRCR045754 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#c 037285101 SENTENCE SUSPENDED JAIL 25D JAIL 301) FINE $250 PROBATION ly DCI 00373688 PAGE 2 OF 3 DISP EFF DAT 19980115 19980115 19950115 19980115 04 ARRESTED/TAKEN INTO CUSTODY 19901104 AGENCY: IA0520200 IOWA CITY PD CHARGE NO— 01 IA STATUTE IA708-2A(2B)(3B) ASSAULT WITH INJURY/DOMESTIC/ENHANCED TRK#! 044597001 COURT DISPOSITION AGRNCY; IA052015J JOHNSON CO DIST COURT COUNT NO— 01 IA STATUTE: IA708-2 ASSAULT CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 044597001 SENTENCE DISP EFF DAT JAIL 1D 19990223 An arrest without disposition 18 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 response can only include public criminal history data. Under Iowa law, moat 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(16). Additionally, criminal history data concerning convictions for certain juvenile sex offenses can be found on the Iowa Sex Offender Registry: http://www.iowaaexoffender.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). c~j N CD C ;3Z III �D This response can only include public criminal history data. Under Iowa law, moat 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(16). Additionally, criminal history data concerning convictions for certain juvenile sex offenses can be found on the Iowa Sex Offender Registry: http://www.iowaaexoffender.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). Aug. 3.2021 12:44PM DCI 10WA No.8049 P. 4 IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD I$ BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION C,IOWADOT R SIMPLER I CUSTOMER DRIVEN vvww•iowado�goy SMARTER I DNya & laarldflc~1 se4rim PO Box 92041 Des Mores. lA 50906920/ Phone. 515.244.9124 1 Fax 515.239-1837 Inquiry 8/17/2021 Date: '016� Customer #: 1833101 Name: Fuhrmeister, Timothy Iowa City, IA 522402117 William Address: 1401 Marcy St Certified Abstract of Driving Record DL/ID #: 713XX1449 (IA) CDL Permit Class: None Class: D Audit #: 3050110 Issue Date: 08/01/2018 History Information CLEAR DRIVING RECORD Name: Fuhrmelster, Timothy William DL/ID: 713XX1449 (IA) CDL Permit Issue None Date: CDL Permit None Expiration Date: CDL Permit None Endorsements: CDL Permit None Restrictions: ID Status: None DL Status: VAL CDL Status: - None L_ CDL Permit ELG Status: CDL Cert Status. None `1 i CDL Med Status: None r.1 Pursuant to Iowa Code §321.10, I, Darcy Doty, 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: Fuhrmeister, Timothy William DL/ID: 713XX1449 (IA) Expiration 08/18/2024 '016� Driver & Identification Date: City/State: Iowa City, IA 522402117 Endorsements: Chauffeur 3 Mailing 1401 Marcy St Restrictions: Corrective Lenses Address: Restriction None Mailing Iowa City, IA 522402117 Supplement: City/State: Date of 8/18/1968 Birth: Sex: M History Information CLEAR DRIVING RECORD Name: Fuhrmelster, Timothy William DL/ID: 713XX1449 (IA) CDL Permit Issue None Date: CDL Permit None Expiration Date: CDL Permit None Endorsements: CDL Permit None Restrictions: ID Status: None DL Status: VAL CDL Status: - None L_ CDL Permit ELG Status: CDL Cert Status. None `1 i CDL Med Status: None r.1 Pursuant to Iowa Code §321.10, I, Darcy Doty, 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: Fuhrmeister, Timothy William DL/ID: 713XX1449 (IA) A8/17/2��20021��^��^""" """ 2 2. '016� Driver & Identification Services Iowa Department of Transportation