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Home My WebLink About20-034� r 1 CITY OF IOWA CITY 410 East Washington Street Iowa City. lona 52240-1826 1319) 356-5040 1319) 356-5497 FAX 1. Name(REQUIRED) _ IDENTIFICATION NO. 2 0 - O 3 I -I (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 2. Address (REQUIRED) %%30 1 o-llr� QIP\ First Middle 3. Contact Information (REQUIRED) Email: Cell Phone: 5) �- 53 7 ff-jy 2 (Al written communication sent via email) 4a.Driver's License expiration date(REQUIRED) /5'�Z•�c�ta b. Taxicab Business Name (REQUIRED) 1 e)l a., Clv 5. Prior experience in transportation of passengers: 6. Have you ever been arrested /charged with any misdemeanors and/or felonies in this State or elsewhere? N Type of offense What happened to the charge? (Circle one) Where When --t Convicted Dismissed Deferred Suspended Plead Guilty Cih_ �.: Have you been arrested / charged with any traffic offenses in the last five years? 1. /e Type of offense !L -7 here 16 {Wheis �rldtr.0o. iP�n/flJo+ICn 9ti' NIK to-w/y age i 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 certify that I have Issued to me by the Iowa Department of Transportation a valid Driver's license number 13. 00a -3(4U issued on 13-'J..o18 expiring on 7.9,1.• 2rx� . 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, 1 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, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant_Date f tMf Ht1Ntf1f111f itt1N11N4#f f ttNN11fN11N}N*MNt#*tI,111NtftNN11}ktf Yt1#Itf NNtih4tfilNlNtttfNN#+HltltfYtf N#ttf}N#f tN*N4fifN STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by on this day of Notary Public In and for the State of Iowa YfN#R#hNAilfGNte#}#Y,##F#MI/#MMI/#}Y##}}#M###R######}}##N#4#N#NNRR*kMIM1l}#RMNf#M:}Rk#N1,N1t##fk#NMe/kHtNN#Nt##*f##MNAi�Y##Nh#Y##}FY# 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 Slg a of Police Chief or designee Date AFTER APPROVAL BY THE CITY CLERK YOU ARE AUTHORIZED TO DRIVE A TAXICAB IN -IOWA C)'1X FOR NO MORE THAN ONE YEAR FROM THE DATE LISTED BELOW, — Co Ci A � LL6- Signature of City Clerk or eslgnee Date ? Office Use Only Approved application DCI report State certified driving record Websfte update C4etlJTA%IDRIVWGEAPPLM8emended.DOC 1412018 oaAug.25.20201:10;00A4Cab DCI IOWA fAW9me;No.2180 P. 1/2u= F A X STATE OF IOWA Criminal History Record Check Request Form Mail or Fax comaletod fmw to: Iowa DMsioo of Crimioal hm"tigation Support Operadow Bureau, 14 Floor US L 70 Strut Des Metues, Iowa $0319. (515) 72"066 (515)725.6080 Fax ACI Account Number: 9967-F (ifepptiobk) Read rou is to: Name Yelldw,4ab of Iowa City A.ddreas P.O. Box 428 Iowa City, Iowa 62214 Phalle 319 33"777 PaY 319-3594142 Iowa Criminal History Record Check Res ul (D we we y)% As of D •aS a search of the provided name and date of birth revealed: A� No Iowa Criminal history Record found with DCI LLO Qa g CM ce O 13rows CIimtaei matory Record attached, DCx # ' H Q ? co initials J V Q DCT DCI -77 (updated 06-26-2018) Received Time Aug. 24. 2020 12:28PM No. 2004 Page I of Aug. 25. 2020 10:01AM DC[ IOWA No. 2180 P. 2,2 DISCLAIMER 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: htto://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). N 0 N N CAe"! DoT SMARTER I SIMPLER I CUSTOMER DRIVEN vvww.lowadogov Driver & IdslRricusion services PO Box 92N I Des Mures, IA 503059201 Phare 516244-91241 Fax 515-23W1837 Certified Abstract of Driving Record Inquiry Date: 8/24/2020 DL/ID #: 236DD0596(IA) Customer #: 4243013 Name: Stonebraker, Class: D ID Status: None Stephen Franklin Address: 931 Boston Way Apt Audit #: 2894625 DL Status: VAL 3 Issue Date: 06/13/2018 CDL Status: None City/State: Coralville IA Expiration Date: 05/22/2026 CDL Cert Status: None 522411248 Endorsements: Chauffeur 3 CDL Med Status: None Mailing Address: 931 Boston Way Apt Restrictions: NONE Restriction None 3 Supplement: Date of Birth: 05/22/1985 Mailing Coralville, IA Sex: M City/State: 522411298 History Information Convictions Citation Date Conviction Date ACD Explanation Count Ju* 06/27/2018 07/17/2018 Improper Polk IA. . Registration 07/23/2018 08/10/2018 Improper Dallas - IA ;J Registration " 07/24/2018 08/06/2018 Improper Polk - IA ,Registration Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Name: Stonebraker, Stephen Franklin DL/ID: 236DD0596 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: 6/24/2020 Name: Stonebraker, Stephen Franklin DL/ID: 236DD0596 Driver & Identification Services Iowa Department of Transporation