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Home My WebLink About13-232 rAuthorization Number 1 (Office Use Only) CITY OF IOWA CITY APPLICATION FOR TAXI DRIVER (Police Department review must be made 410 East Washington Street between 8 a.m.to 3 p.m., Monday—Friday.) Iowa City. Iowa 52240-1826 (319) 356-5040 (319) 356-5497 FAX First Middle Last 1. Name �!Iz�Gi� (P•k4 y l�N 2. Mailing Address D l S . T u`' t� L�r / I =.A S ZZ`f o 3. Telephone: Home ��l 9 `'g73 1 Other: 4. Prior experience in transportation of passengers: C 43 1),2- ti'' G z„,00, V uJA— C I 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? NO . Type of offense Where When 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? NO 'p E /2-12- 0 / 9 °l 3 Type of Offense Where When • 7. Have you been convicted of any traffic offenses in the last five years? J 2I- ,� �7 f�r'� S o. Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? /1<-9- 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) NC) 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). (OVER FOR REQUIRED SIGNATURE AND NOTARY) derkflaxidrivbadg 03/2013 4 hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number 0 7121.3 f0 . I understand that if I falsely answer any questions in this application, that this application ma� denied. I understand that if I falsely answer any of the questions in this application, that this application will 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 a license 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 Date STATE OF IOWA COUNTY OF JOHNSON ) tf 361 Stib�cribed and sworn to bef2 e me by I C(.4-11- C i C� ( r�n On this day of —7 <ELLIE K.TUTTLE Notary Public in and for the State of Iowa i Commission um My Corr) ssires ***********************************,w..wl /41* **********************************************x*****************x**x.r******** I have reviewed this application, DCI report, and the State certified driving record of this applicant and have deter- mined that there is no information which would indicate that the issuance would be detrimental to the safety, health or welfare of residents of the City of Iowa City(Title 5, Chapter 2, City Code). Signa re of P. cor hie sr designee Date YOU ARE NOT VALID TO DRIVE A TAXI IN IOWA CITY UNTIL AUTHORIZATION IS RECEIVED FROM THE CITY CLERK'S OFFICE. Authorized taxi driver names are placed on the city website at icgov.org. -)/T , Signa e of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 1/2" (width)and 51/2" (height)and prominently displayed to all passengers. ****************************************************************** **************************************************************************** Office Use Only Approved application DCI report State certified driving record Website update • • derk taxidrivbadgeapp2010.doc 03/2013 IO •WA LISA DRIVER LICENSE L IA . • ",Irr ; --.--FLYNN ? ° ' ~ ; PATRICIA KELLY 7 . 4 f -.., 3409 S JAMIE LN ' Y �"l y x4 1? IOWA CITY,14 2240 tis OL No.807YY8136 :" A!ss 09/25/2013 [xr 10/ /2013 Y f ClassD Enda ...FLA { �-:. Res4ictionj R9t l5'-0d" • ��,� B . EyosQW 0'�__'DOB1.1/74/1974 . ogOa:Y OO 773736014FP0924F1411170 _ .. _ - • • . F - Iowa Department of Transportation ..t. Office of Driver Services (Toll Free)800-532-1121 • PO Box 9204,Des Manes,IA 50306-9204 515-244-9124 1111. FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 9/25/2013 DL/ID It: 807YY8136(IA) Customer It: 5082838 Name: Flynn, Patricia Kelly Class: D ID Status: None Address: 3409 S JAMIE LN Audit it: 7373601 DL Status: VAL Issue Date: 09/25/2013 CDL Status: None City/State: IOWA CITY,-IA 522403078 Expiration Date: 11/14/2017 CDL Cert Status: None Endorsements: 3 CDL Med Status: None Mailing Address: 3409 5 JAMIE LN Restrictions: Corrective Lenses Restriction None _ Date of Birth: 11/14/1974 Supplement: Mailing City%State: IOWA CITY,IA 522403078 Sex: F History Information Accidents-Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number JUR 11/10/2010 601044 ......_.�..,»..�,_.__..�. IA 1 Name: Flynn, Patricia Kelly DL/ID: 807YY8136 Pursuant to Iowa Code §321.10,4y Kim SnookcDirector of Office of Driver Services, Iowa Department of Transportation, do hereby certify that I am the custodian of the records held by the Office of Driver 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: Ps'`ora . 9/25/2013 IOWA ..y'*6 4 x s* .D. O. T. ?*r '/'' ,`6v•du s-÷-, Office Iowac Department ervices rviceansportation Name: Flynn, Patricia Kelly DL/ID: 807YY8136 G Jep• JU. CUD Y:uiHm viv o! Ur 'mivai (nve.11I (;aiIVil nV. IJJI I. ut II - r ie el ■ ■ - STATE OF IOWA ""` ;•41 •- Crilllivaal History Record Cheek -, 1,_ `7, It: Request 3!orm x ,,,, .. EIt•. r DCI Account Number: 9967-F • (if applinsblo) To; lows Division of Criminal investigation From: Yellow Cab of Alava City 'Support Operations Bureau,1"Floor • P.O.Boa 428 215 E,7r"Street • Des Moines,lows 50319 Iowa City,IA. 52244 (515)725.6066 (515)7236080 Fax (319)338.9777 • Pbone: • Flus (319)339-7302 I am requesting en Iowa Criminal History Record Chest on: Last Name(nuaduo,y) ' First Name(nundalowy. Middle Notate(rowmmcnecd) flq N l-1 tkl-P-w , lee Date of Birth cmmdeory) Gender(mend.nnQ '�, •S•oclal•Secarity Numb:;(leoommcaaoa) 11 ` 14114. .. [Male ttl emale q 2 D— D Ic —(0 07 3 Waiver Information:Without a signed waiver from thesalnjectof the request;a complete cringes'history record m a)s_na . ho releasable,per p ry' by. P Codteflowa,Che tor692,2.ForFom leteerlm(nelblefo retordiuformatien,agallowMlaw:9N�ftlq�RiK�:' obtain a waiver signature from the subject of the roast /d'• • Waiver Release:I Mthy glue pemnkstoa for ala;bow togocsstingofficial to conduct no town aimiral aunty locwd cis&with du Division ofOimclel lnvesdgedos(DCO.My aimiru(history dim meaning me tot isnoimdoed by there may be Neves at Wowed ny lsw. Waiver Signature; . L , • • Iowa Criminal History Record Check Results Cta> (neonly) g As of /- 30 - 13 ,a search of the provided name and date of birth revealed: No Iowa Criminal History Record found with DCI L/ J Iowa CriDaanal HisWry Record attached,DCI# 4/7/V02 a ' \ • DCI initials y(J • • DCI-77(08/25/10) ' Received Time Sep. 25. 2013 10:43AM No. 1237 Sep. 30. 2013 9:09AM Div of Criminal Investigation No. 7557 P, 2/2 IOWA CRIMINAL HISTORY DCI 00471422 COURT DISPOSITION PENDING PAGE 1 OF 1 STATOR UNKNOWN DATE PRINTED- 2013/09/30 DCI;00471422 NAME: PLYNN,PATRICIA KELLY DOB SEK RAC HGT WGT EYE HAIR SRN POD 19741114 F W 504 140 BLU ELN PAR TK ADDITIONAL IDENTIFIERS TAT BREAST TAT L ANKL TAT R ANKL CCH RECORD v** 01 ARRESTED 19931113 AGENCY: IA0530200 MONTICELLO PD CHARGE NO- 01 IA STATUTE IA321J-2 OWI-1ST OFFENSE TRK#: 004685701 COURT DISPOSITION AGENCY: IA053015J JONES CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2 OPER VEE WH INT OWI TRIM: 004685701 SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 19940114 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OP CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO NON-LAW ENFORCEMENT AGENCIES BY THE DCI. IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS EASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT.OF YOUR INQUIRY. DIVISION OP CRIMINAL INVESTIGATION