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Home My WebLink About21-042I r 1 �.:a -02 MN�� CITY OF IOWA CITY 410 East Washington Street Iowa City. Iowa 52240-1826 (319) 356-5040 (319) 356-5497 FAX 1. Name (REQUIRED) _ 2. Address (REQUIRED) IDENTIFICATION NO. 1 Dq — (Office se Only) APPLICATION FOR TAXICAB / MOTORIZED PEDICAB VEHICLE DRIVER (Police Department jrexipw msfst be rMde between 8 a.m. to 3 p.m., Monday - Friday) Failure to complete the "required" information will result in denial of the aoalication Last First 37e( 74 ? Middle 3. Contact Information (REQUIRED) Email Cell Phone: (Al written comnYunication sent via email) 4a. Driver's License expiration date (REQUIRED) Drj'l i ZC 7- b. b. Taxicab Business Name (REQUIRED) le -(C-0, 5. Prior experience in transportation of passengers: _1 zzt=- 6. Have you ever been arrested/ charged With any misdemeanors and/or felonies in this State or elsewhere? Where When C) -E7 What happened to the charge? (Circle one) _ 7 Convicted Dismissed Deferred Suspended Pad Gullty Other 7. Have you been arrested / charged with any traffic offenses in the last five years? 8. Tvoe of offense Type of offense �7 rcJ��L What happened _ 1 Convicted Dismissed Deferred Suspende Plead 1ilty Other Has your driver's license or chauffeur's license been suspended or revoked in the last five years? Where When Z0 Efa/s °) 9. Have you ever aF Where When 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 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 (forrmiWailableupon request). I hereby certify that I have issued to me by the Iowa Department of Transportation a` valid Drivers license number 7�SiftI ftl issued on !1 Zoz4axpiring on TYf 0t;'-tvLS I 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 applicatio , and I e ree that, if authorization to be a taxicab driver is granted, to comply at all times with all of the provisions of T* 5, Chapter 2, Of th4ity Code. (Needs to be signed in front of a Notary Public) Signature of STATE OF IOWA ) COUNTY OF JOHNSON ) Date C LS- " L Subscribed and sworn to before me by —irt k eD iyrrQS on this yt_p day of r� �. Notary Public in &d for the State of Iowa N "W 72"2! ' MY EhpYM 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 101 20 2 J -- i 8/Z% /Zoz Si at o Ice 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 ClerklrAXIDRIVBADGE PPL9201 Bamendad.DOC 3o 2 zl D to 04/2018 I STATE OF IOWA Criminal Mstojry Record Check Request Fotr�0 Mail or Fax completed fomes to: I ' Iowa Division of Criminallavesti8ation Support Operations Bureau, I' Floor 215 el 7°' street Des Moines, Iowa 50319 (516)T25-6066 (515) 2-1-6080 Pax' i I am requW66 an Iowa Criminal histoxyRecord Check on: DCT Account Number: 9967-F (if applicable) Spud results to: Name fellow Cab of Iowa Ciri ' AAdress P.O. Box 428 t Iowa Citi, loft 52344 Phone -519) 33"rn i Fax 31"59-4142 ! I:as�tit..: v an r :ter fn�wd�i=- ^..^tiw ., ��f��amme •.. � •tom. ' C ) yl w o "e❑Fewale y�r ��- '7C -5 =00, � 41 r��y � tirr'� t � �•. r .+ �.e. 'J3c�cii,.a y� r1dTmv ':reeaath�4'�``. oYt":" .t 3`,S �. n....� TV A�t.Jy(gy�'j^.rle,je ��St y�1 �`r<�hv m� S att �'�..u..9r.4;IK1L•®A. r�Ode y ~-.L„ yF d v �+.. ONON7' hrv"fi-. res\ gxi•`y�' 7i �1 . i''i; i y.i'r ��. 1,. �` f��1k1..+ i�`�� „�.�' r '� %•'.'i a ,.j, .. ,� uY �tS�Fii6�,•Ynfa!h.:. �towa 1 nmmalrns _ �curu,• xmyxnesulW NainMW ;�a7: O ! y As of dupex°4 date of birth revealed: Ia y pcst� '/ results: € fir.' o ❑ No Iowa Criminal Ilistoty Record found with.'�I, �0 s Iowa Criminal History Rewzi%'� DCI initials 06-26-201.8) psi 1 oft i Received Time Aug. 16. 2021 10:18AM No -9951 IOWA CRIMINAL HISTORY DCI 00626884 MISDENHANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED - 2021/08/19 DCI:00626884 -- NAME: WOODS,JUSTIN MICHAHL DOB SEX RAC HOT NOT EYE HAIR- : t 0 ?OP 'C„ (, 19820403 M W 507 110 GRN BLK FAR IA ADDITIONAL IDENTIFIERS CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 20000813 AGENCY: IA031DOOO DUBUQUE CO so CHARGE NO- 01 IA STATUTE IA321J-2 OWI TRK#: 053788401 COURT DISPOSITION AGENCY: IA031015J DUBUQUE CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J-2 OWI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 053788401 DRUNK DRIVING SCHOOL SUBSTANCE ABUSE EVALUATION SENTENCE JAIL 21) FINS $1000 PROBATION 2Y SUSPENDED 90D DISP EFF DAT 20010411 20010411 20010411 20010411 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 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! httpi//www.iowanexoffender.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 he 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. DIVISION OF CRIMINAL INVESTIGATION 1011 AUG 30 All 8: 40 iQVVA CIT Y, 10 f % QJ10WADOT,wwW o ,0 oy SMARTER I SIMPLER I CUSTOMER DRIVEN g W" & mar"kagm sxvws PO Box 92M I Des Moines, IA 5030&9201 Phone 515-211-9125 1 Fax 515-299-1837 Certified Abstract of Driving Record Inquiry Date: 8/19/2021 DL/ID #: 705XX9421(IA) Customer #: 1409870 Name: Woods, Justin Class: C ID Status: EXP Michael Address: 3701 2nd St Trlr 27 Audit #: 5029083 OL Status: VAL Issue Date: 10/09/2020 CDL Status: None City/state: Coralville IA Expiration Date: 04/03/2025 CDL Cert Status: None 5224132117 Endorsements: Motorcycle CDL Med Status: None Mailing Address: PO BOX 5264 Restrictions: NONE Restriction None Supplement: Date of Birth: 04/03/1982 Malliny CORALVILLE, IA Sex: M City/state: 522410264 History Information Convictions Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Name: Woods, Justin Michael DL/ID: 705XX9421 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 Ankeny, Iowa I 1 this date: 8/19/2021 Name: Woods, Justin Michael DL/ID: 705XX9421 Dtiver & Identification Services Iowa Department of Transporation n G �.. b µTt 3 -t- Y �