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Blank Illinois Perc Card Form

The Illinois Permanent Employee Registration Card (PERC) is a crucial document required for individuals seeking employment in various security-related fields within the state. This card must be renewed every three years, and specific eligibility criteria must be met to obtain it. Understanding the application process and requirements is essential to ensure timely and successful registration.

Outline

The Illinois Permanent Employee Registration Card (PERC) form serves as a critical document for individuals seeking employment in various security-related roles within the state. This form outlines the necessary steps for application, including the completion of specific information and the submission of required fees and documents. Applicants must be at least 18 years old and provide their U.S. social security number, which is mandatory for processing. The form also details exemptions for certain professionals, such as peace officers and those working in regulated nuclear facilities, who may not need to obtain a PERC. It is important to note that a PERC is valid for three years, and renewal notifications are sent via email approximately 90 days prior to expiration. Additionally, the application process involves a security clearance, which includes a criminal background check through fingerprinting. Applicants are advised to carefully follow the instructions to avoid delays in processing. Failure to provide complete and accurate information can result in the rejection of the application. The PERC form is a key component in ensuring that individuals meet the regulatory standards necessary for employment in the private security sector in Illinois.

Sample - Illinois Perc Card Form

INSTRUCTIONS FOR MAKING APPLICATION FOR A

PERMANENT EMPLOYEE REGISTRATION CARD (PERC)

NOTICE: The PERC shall expire on May 31, 2018 and every 3 years thereafter. You will receive your PERC renewal by e-mail approximately 90 days prior to the expiration date of your PERC. If you possess a valid Illinois detective, security contractor, alarm contractor, or locksmith license, then a PERC is not required to work for a licensed agency.

Before completing the application package, read each of the steps below and follow them as they apply to you. This will aid you in accurately completing your application and eliminate any delay in processing. The application which you submit is valid for three years from the date of receipt.

EXEMPTIONS: A peace officer as defined in the Private Detective, Private Alarm, Private Security, Fingerprint Vendor and Locksmith Act is exempt from the requirements relating to the possession of a permanent employee registration card (PERC). The employing agency shall remain responsible for any peace officer employed under this exemption.

A person employed as an unarmed security guard at a nuclear energy, storage, weapons, or development site or facility regulated by the Nuclear Regulatory Commission who has completed the background screening and training mandated by the rules and regulations of the Nuclear Regulatory Commission is exempt from registration for a Permanent Employee Registration Card.

NOTE: If you have been issued a Permanent Employee Registration Card in the past, you may not apply for an additional card. If your original PERC has expired, contact the Division's Call Center at 1-800-560-6420 and request a renewal. Please indicate any change of address on your renewal.

If your PERC has been lost you can print your PERC on-line at www.idfpr.com by selecting the e-License Search link.

If you have applied for a Permanent Employee Registration Card within the past 3 years but did not complete the application process, DO NOT submit another application. Contact the Division's Call Center at 1-800-560-6420 and request the status of your application.

APPLICATION INSTRUCTIONS

1.Complete the application in its entirety. An incomplete or illegible application will be returned.

2.Applicant must be at least 18 years of age to apply for a PERC in an unarmed capacity.

3.Disclosure of your U.S. social security number, if you have one, is mandatory, in accordance with 5 Illinois Compiled Statutes 100/10-65 to obtain a license. The social security number may be provided to the Illinois Department of Public Aid to identify persons who are more than 30 days delinquent in complying with a child support order, or to the Illinois

Department of Revenue to identify persons who have failed to file a tax return, pay tax, penalty or interest shown in a filed return, or to pay any final assessment or tax penalty or interest, as required by any tax Act administered by the Illinois Department of Revenue, or to other entities for verification of identification.

4.Submit a non-refundable registration fee of $55.00, made payable to the Department of Financial and Professional Regulation.

5.Submit the appropriate security clearance documents (See Security Clearance below).

6.Forward application, copy of the electronic fingerprint receipt, and fee payment to:

Illinois Department of Financial and Professional Regulation

ATTN: Division of Professional Regulation

P.O. Box 7007

Springfield, Illinois 62791

SECURITY CLEARANCE

Permanent Employee Registration Cards will not be issued until security clearance is completed. Reference the page entitled Important Notice / Criminal Background Check Information for details on fingerprinting.

The security clearance requirement is waived for those applicants who submit supporting document VE-PEC, verifying their retirement from a peace officer position within one year of application. To order the VE-PEC form Contact the Division's Call Center at 1-800-560-6420.

Additional application forms can be downloaded from the IDFPR Web site at www.idfpr.com.

DPR-PERC (Instructions Revised 6/16)

Packet updated 6/30/16

IMPORTANT NOTICE

CRIMINAL BACKGROUND CHECK INFORMATION

Individuals applying for licensure for professions that require fingerprints must submit to a criminal back- ground check and provide evidence of fingerprint processing from a fingerprint vendor licensed by the Department. Fingerprints must be taken within 60 days from the date that the application is submitted to the Department or the Department’s testing vendor.

=Applicants may contact a licensed fingerprint vendor to schedule an appointment for fingerprinting by going to https://www.idfpr.com/FPVendor.asp. The Illinois State Police will transmit electronic results of fingerprint processing to the Department. A receipt issued by a licensed fingerprint ven - dor agency must be submitted with the application fee. The receipt shall be issued by the fingerprint vendor at the time the fingerprints are obtained.

=Out-of-State applicants who are unable to schedule an appointment for fingerprinting through a licensed fingerprint vendor need to complete the following steps:

=Obtain one (1) Illinois State Police (ISP) Fee Applicant Card for processing. Applicants may contact the Department at 1-800-560-6420 or send an email request on your profession page of the Department website at www.idfpr.com. The ISP will transmit electronic results of the fingerprint processing to the Department.

=Complete Section 1 of the Identity Verification Certifying Statement form.

=The Fee Applicant Card shall be taken to a police department in another state to obtain classifiable prints.

=Section 2 of the Identity Verification Certifying Statement shall be completed and signed by the police department.

=Go to www.idfpr.com to select a licensed fingerprint vendor that has “Card Scan” capability. Contact the vendor to determine the fee for a “Card Scan”.

=Mail the original Identity Verification Certifying Statement (with Sections 1 and 2 completed), Fee Applicant card and fingerprint fee to the licensed fingerprint vendor selected from the Division of Professional Regulation website.

=Mail the completed application, licensing fee and a copy of the Identity Verification Certifying Statement (with Sections 1 and 2 completed) to the Division of Professional Regulation.

PRIVACY STATEMENT

I, the undersigned, hereby authorize the release of any criminal history record information that may exist regarding me from any agency, organization, institution, or entity having such information on file. I am aware and understand that my fingerprints may be retained and will be used to check the criminal history record information files of the Illinois State Police and/or the Federal Bureau of Investigation. I also understand that if my photo was taken, my photo may be shared only for employment or licensing purposes. I further understand that I have the right to challenge any information disseminated from these criminal justice agencies regarding me that may be inaccurate or incomplete pursuant to Title 28 Code of Federal Regulation 16.34 and Chapter 20 ILCS 2630/7 of the Criminal Identification Act.

IL486-2052 NEW 4/15

If you possess a valid Illinois Detective, Security Contractor, Alarm Contractor or Lock- smith license, then a PERC is NOT required to work for a licensed agency.

APPLICATION FOR PERMANENT EMPLOYEE

REGISTRATION CARD

IMPORTANT NOTICE: Submit a non-refundable registration fee of $55.00 made payable to IDFPR. Completion of this form is necessary to accomplish the requirements outlined in 225 ILCS 447/1 et. seq. (Illinois Compiled Statutes). Disclosure of this information is REQUIRED. Failure to provide any information will result in this form not being processed.

FOR OFFICIAL USE ONLY

1.	NAME (Last Name, First Name, Middle Initial)			2.	UNITED STATES SOCIAL SECURITY NUMBER:
					(See Box # 16 Below.)

3.	HOME STREET ADDRESS (No P.O. Boxes)	4.	CITY	5.	STATE	6. ZIP CODE	7. COUNTY

8.	E-MAIL ADDRESS (REQUIRED)	9.	DATE OF BIRTH (M/D/Y)	10. AGE (18 yrs min.)		11. TELEPHONE NUMBER
						(__ __ ___ ) ___ ___ ___ — ___ ___ ___ ___

12.Have you been convicted of or pled guilty or nolo contendere to any criminal offense in any state or in federal court? Please do not give details on minor traffic charges, but do include information relating to Driving While Intoxicated (DWI) charges. If yes, attach a personal statement describing the circumstances of the conviction and certified copies of court records of your conviction including the nature of the offense, date of discharge, and a statement from the probation or parole office. In general, a criminal conviction by itself

does not usually result in denial of licensure.	Yes	No

13. Have you ever been discharged other than honorably from the armed services or from a city, county, state,
or federal position? If yes, attach explanation.	Yes	No

14.Do you have any disease or condition that interferes with your ability to perform the essential functions of your profession, including any disease or condition generally regarded as chronic by the medical community, i.e., (1) mental or emotional disease or condition; (2) alcohol or other substance abuse; (3) physical disease or condition, that presently interferes with your ability to practice your profession? If yes,

attach a detailed statement, including an explanation whether or not you are currently under treatment.	Yes	No
15. Have you ever had a license or registration denied, suspended or revoked under the Illinois Private Detective,
Private Alarm, Private Security, Fingerprint Vendor and Locksmith Act? If yes, attach explanation.	Yes	No

16.In accordance with 5 Illinois Compiled Statutes 100/10-65(c), applications for renewal of a license or a new license shall include the applicant's Social Security number, and the licensee shall certify, under penalty of perjury, that he or she is not more than 30 days delinquent in complying with a child support order. Failure to certify shall result in disciplinary action, and making a false statement may subject the licensee to contempt of court.

Are you more than 30 days delinquent in complying with a child support order?

Yes

No

(NOTE: If you are not subject to a child support order, answer "no.")

17.In accordance with 20 ILCS 2105-15(g), "The Department shall deny any license application or renewal authorized under any licensing

Act administered by the Department to any person who has failed to file a return, or to pay the tax, penalty, or interest shown in a filed return, or to pay any final assessment of tax, penalty, or interest, as required by any tax Act administered by the Illinois Department of Revenue, until such time as the requirement of any such tax Act is satisfied."

Are you delinquent in the filing of state taxes?

Yes

No

I hereby certify that I personally completed this application, that the answers appearing hereon are true and correct to the best of my knowledge and belief and that I am legally authorized to sign this application.

Signature (in full-use no initials)

Date

I UNDERSTAND THAT FEES ARE NOT REFUNDABLE. My signature above authorizes the Department of Financial and Professional Regulation to reduce the amount of this check if the amount submitted is not correct. I understand this will be done only if the amount submitted is greater than the required fee hereunder, but in no event shall such reduction be made in an amount greater than $50.

RETURN TO: ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION

ATTN: DIVISION OF PROFESSIONAL REGULATION, P.O. BOX 7007, SPRINGFIELD, ILLINOIS 62791

IL486-1120 4/19 (DE)

IMPORTANT NOTICE: Completion of this form					EMPLOYEE NUMBER
IMPORTANT NOTICE: Completion of this form		EMPLOYEE'S STATEMENT
is necessary to accomplish the requirements		EMPLOYEE'S STATEMENT
outlined in 225 ILCS 447/1 et. seq. (Illinois	To be retained in employee's personnel file by the em-
Compiled Statutes). Disclosure of this information	To be retained in employee's personnel file by the em-				DATE OF EMPLOYMENT
is REQUIRED. Failure to provide any information			ploying agency.
will result in this form not being processed.

NAME AND ADDRESS OF EMPLOYING AGENCY				NAME OF EMPLOYEE	SOCIAL SECURITY NUMBER

				ADDRESS OF EMPLOYEE (Include Street,	City, State, and ZIP Code)


				DATE OF BIRTH (Month/Day/Year)	PLACE OF BIRTH

				E-MAIL ADDRESS (REQUIRED)

Have you been convicted of or pled guilty or nolo contendere to any criminal offense in any state or in	Yes	No
federal court? Please do not give details on minor traffic charges, but do include information relating to
Driving While Intoxicated (DWI) charges. If yes, attach a certified copy of the court records regarding your
conviction, the nature of the offense and date of discharge, if applicable, as well as a statement from the
probation or parole office.

Have you ever been discharged other than honorably from the armed services or from a city, county, state,	Yes	No
or federal position? If yes, attach explanation.	Yes	No
or federal position? If yes, attach explanation.

Do you have any disease or condition that interferes with your ability to perform the essential functions of
your profession, including any disease or condition generally regarded as chronic by the medical community,	Yes	No
i.e., (1) mental or emotional disease or condition; (2) alcohol or other substance abuse; (3) physical disease	Yes	No
or condition, that presently interferes with your ability to practice your profession? If yes, attach a detailed

statement, including an explanation whether or not you are currently under treatment.

Have you ever had a license or registration denied, suspended or revoked under the Illinois Private Detective,

Private Alarm, Private Security, Fingerprint Vendor and Locksmith Act? Yes No If yes, attach explanation.

Please state business or occupation engaged in for the five (5) years immediately preceding the date of execution of this statement, the location of such business or occupation, and the names of employers, if any.

Date:

Signature of Employee:

IL486-0495 6/16 (DE)

Click for PDF

Form Information

Fact Name	Details
Expiration of PERC	The Permanent Employee Registration Card (PERC) expires every three years, with the last expiration noted as May 31, 2018.
Renewal Notification	Renewal notifications are sent via email approximately 90 days before the expiration date of the PERC.
Application Validity	Once submitted, the application for a PERC is valid for three years from the date it is received by the Department of Financial and Professional Regulation.
Exemptions	Peace officers and certain security personnel at regulated nuclear facilities are exempt from needing a PERC.
Application Fee	A non-refundable registration fee of $55.00 must be submitted with the application.
Governing Law	The PERC application process is governed by the Illinois Compiled Statutes, specifically 225 ILCS 447/1 et seq.

Detailed Guide for Filling Out Illinois Perc Card

Completing the Illinois Permanent Employee Registration Card (PERC) form involves several important steps. Following these instructions carefully will help ensure that your application is processed smoothly and without delays.

Begin by filling out the application completely. Ensure that all sections are filled in clearly and legibly.
Verify that you are at least 18 years old, as this is a requirement for applying for a PERC in an unarmed capacity.
Provide your U.S. social security number. This is mandatory and will be used for identification purposes.
Prepare a non-refundable registration fee of $55.00, made payable to the Department of Financial and Professional Regulation.
Gather and submit the required security clearance documents. Refer to the security clearance section for specifics.
Send your completed application, the electronic fingerprint receipt, and the fee payment to the following address:

Illinois Department of Financial and Professional Regulation
ATTN: Division of Professional Regulation
P.O. Box 7007
Springfield, Illinois 62791

After submitting your application, it will undergo a review process. You will receive further communication regarding your application status, including any additional steps that may be required for completion.

Obtain Answers on Illinois Perc Card

What is the Illinois PERC Card?
The Permanent Employee Registration Card (PERC) is required for individuals working in unarmed security positions in Illinois. It is issued by the Illinois Department of Financial and Professional Regulation (IDFPR) and is valid for three years.
How do I apply for a PERC Card?
To apply for a PERC Card, you must complete the application in its entirety, pay a non-refundable fee of $55, and submit the required security clearance documents. Additionally, you must provide your U.S. social security number and a copy of your electronic fingerprint receipt.
What are the age requirements for applying?
Applicants must be at least 18 years old to apply for a PERC Card in an unarmed capacity.
What happens if my PERC Card expires?
Your PERC Card will expire every three years. You will receive a renewal notice via email approximately 90 days before the expiration date. If your card has expired, you must contact the IDFPR to request a renewal.
Are there any exemptions from needing a PERC Card?
Yes, certain individuals are exempt from needing a PERC Card. Peace officers and unarmed security guards at specific nuclear sites regulated by the Nuclear Regulatory Commission do not need to obtain a PERC.
What if I have previously held a PERC Card?
If you have been issued a PERC Card in the past, you cannot apply for an additional card. If your original card has expired, you should request a renewal instead.
What is the process for fingerprinting?
Applicants must submit to a criminal background check and provide evidence of fingerprint processing. Fingerprints must be taken within 60 days of submitting the application. You can schedule an appointment with a licensed fingerprint vendor to have your fingerprints taken.
What should I do if my PERC Card is lost?
If your PERC Card is lost, you can print a duplicate online by visiting the IDFPR website and selecting the e-License Search link.
Can I apply for a PERC if I have a criminal record?
Having a criminal record does not automatically disqualify you from obtaining a PERC Card. However, you must disclose any convictions and may need to provide additional documentation regarding the circumstances of those convictions.
How can I check the status of my application?
If you have applied for a PERC Card within the past three years but did not complete the process, do not submit another application. Instead, contact the IDFPR Call Center at 1-800-560-6420 to check the status of your application.

Common mistakes

When filling out the Illinois Permanent Employee Registration Card (PERC) form, applicants often make several common mistakes that can lead to delays or outright denials. Understanding these pitfalls can streamline the application process and ensure compliance with the requirements.

One significant error is submitting an incomplete application. Each section of the form must be filled out entirely. If any part is left blank or is illegible, the application will be returned. It is crucial for applicants to double-check their submissions to ensure that all required fields are completed before sending in their application.

Another common mistake involves the failure to provide a social security number. The form explicitly states that disclosing this information is mandatory. Applicants who neglect to include their social security number may find their applications delayed or rejected entirely. It's essential to ensure that this number is accurate and clearly written.

Many applicants also overlook the non-refundable registration fee of $55. The fee must be included with the application, made payable to the Department of Financial and Professional Regulation. Omitting this payment will result in the application being returned. Applicants should verify that they have included the correct fee to avoid unnecessary delays.

Additionally, some individuals fail to submit the appropriate security clearance documents. The application will not be processed until security clearance is complete. This means that any required documentation related to background checks must be included. Applicants should review the instructions carefully to ensure all necessary documents are attached.

Another frequent issue arises when applicants do not follow the fingerprinting requirements. Fingerprints must be taken within 60 days of submitting the application, and evidence of this must be provided. Applicants should schedule their fingerprinting promptly to avoid any issues with their application timeline.

Lastly, many applicants do not pay attention to the expiration dates associated with the PERC. The card must be renewed every three years, and applicants should be aware of the renewal process. If a renewal is not submitted on time, individuals may find themselves without the necessary credentials to work legally.

By being aware of these common mistakes, applicants can better navigate the PERC application process and increase their chances of approval. Careful attention to detail and adherence to the outlined instructions will facilitate a smoother experience.

Documents used along the form

When applying for a Permanent Employee Registration Card (PERC) in Illinois, several other forms and documents may be required to ensure a smooth application process. Each of these documents plays a crucial role in verifying eligibility and compliance with state regulations. Below is a list of commonly used forms and documents associated with the PERC application.

Application for Permanent Employee Registration Card: This is the primary form that must be completed in its entirety. It collects essential information about the applicant, including personal details and background information relevant to the licensing process.
Electronic Fingerprint Receipt: Applicants must undergo a criminal background check. This receipt, issued by a licensed fingerprint vendor, serves as proof that the applicant has completed the fingerprinting process, which is a prerequisite for obtaining a PERC.
Identity Verification Certifying Statement: This form is used by out-of-state applicants who cannot access a licensed fingerprint vendor in Illinois. It certifies the identity of the applicant and includes sections that must be completed by a police department.
VE-PEC Form: This document is for peace officers who are exempt from PERC requirements. It verifies the applicant's retirement from a peace officer position within the last year and must be submitted to waive the security clearance requirement.
Personal Statement for Criminal Convictions: If an applicant has a criminal history, this statement must be attached to the application. It should detail the circumstances surrounding the conviction and include certified copies of court records.
Payment Receipt for Registration Fee: A non-refundable fee of $55 is required for processing the application. Proof of payment must accompany the application to ensure it is processed promptly.
Employee's Statement: This form is retained by the employing agency and includes information about the employee's background, including any criminal convictions or conditions that might affect their ability to perform their duties.

Understanding these documents and their purposes can significantly ease the application process for a PERC. Each form serves to protect both the applicant and the public, ensuring that only qualified individuals are granted permission to work in sensitive security roles. Being well-prepared and informed can lead to a more efficient and successful application experience.

Similar forms

Employment Authorization Document (EAD): Like the PERC, an EAD allows individuals to work legally in the United States. Both documents require an application process and verification of identity, ensuring that only eligible individuals can obtain them.
State Security Guard License: This license is similar to the PERC as it permits individuals to work in security roles. Both require background checks and proof of training, ensuring that applicants meet specific standards before they can work in their respective fields.
Professional License Application: Just as the PERC application requires detailed personal information and background checks, many professional licenses demand similar documentation. Both processes aim to confirm that applicants are qualified and trustworthy to perform their jobs.
Fingerprint Clearance Card: This card, like the PERC, is essential for individuals working in sensitive positions. Both require fingerprinting and background checks to ensure the safety and security of the community.

Dos and Don'ts

When filling out the Illinois PERC Card form, there are several important dos and don'ts to keep in mind. Following these guidelines can help ensure your application is processed smoothly and efficiently.

Do complete the application in its entirety. An incomplete form will be returned.
Do ensure you are at least 18 years old when applying for a PERC in an unarmed capacity.
Do provide your U.S. social security number, as it is mandatory for the application.
Do submit the non-refundable registration fee of $55.00, made payable to the Department of Financial and Professional Regulation.
Do include the appropriate security clearance documents with your application.

Don't forget to provide a valid home address; P.O. Boxes are not acceptable.
Don't submit multiple applications if you have already applied within the past three years.
Don't neglect to attach any required documents if you have a criminal history or other relevant circumstances.
Don't ignore the importance of submitting your fingerprints within 60 days of applying.

By adhering to these guidelines, you can avoid common pitfalls and help ensure your application for the Permanent Employee Registration Card is processed without unnecessary delays.

Misconceptions

Misconception 1: A PERC is required for all security-related jobs.

This is not entirely accurate. If an individual holds a valid Illinois detective, security contractor, alarm contractor, or locksmith license, they do not need a PERC to work for a licensed agency. This exemption is crucial for those already licensed in specific roles.

Misconception 2: The PERC is a one-time application.

Many believe that once they obtain their PERC, they will not need to renew it. In reality, the PERC expires every three years. Renewal notices are sent via email approximately 90 days before the expiration date, making it essential to stay aware of renewal timelines.

Misconception 3: Social security numbers are optional on the application.

Some applicants think they can skip providing their social security number. However, disclosing this information is mandatory. It is used for various verification processes, including child support compliance and tax obligations.

Misconception 4: Fingerprinting is not necessary for all applicants.

This is misleading. All individuals applying for a PERC must undergo a criminal background check, which includes fingerprinting. The requirement is strictly enforced to ensure the safety and integrity of the security profession.

Misconception 5: If the application is incomplete, it can still be processed.

On the contrary, submitting an incomplete or illegible application will result in it being returned. Applicants must ensure that all sections are filled out accurately to avoid delays in processing their PERC application.

Key takeaways

When applying for the Illinois Permanent Employee Registration Card (PERC), it is essential to follow the guidelines carefully to ensure a smooth process. Here are seven key takeaways to keep in mind:

Expiration and Renewal: The PERC expires every three years, with renewals sent via email approximately 90 days before the expiration date. Be proactive in checking your email for renewal notifications.
Eligibility: Applicants must be at least 18 years old and possess a valid U.S. Social Security number. Failure to provide this information will delay or deny your application.
Application Completeness: Complete the application in its entirety. Incomplete or illegible applications will be returned, causing unnecessary delays.
Non-Refundable Fee: A registration fee of $55.00 is required and is non-refundable. Ensure that this payment is included with your application to avoid processing issues.
Security Clearance: A criminal background check is mandatory. You must submit evidence of fingerprint processing from a licensed fingerprint vendor, and your application will not be processed until this is complete.
Exemptions: Certain individuals, such as peace officers and specific security personnel at regulated nuclear sites, may be exempt from needing a PERC. Verify your eligibility for any exemptions before applying.
Lost or Expired Cards: If your PERC has expired or been lost, do not apply for a new card. Instead, contact the Division's Call Center for renewal or reprinting options.

By adhering to these guidelines, you can navigate the application process more effectively and avoid potential pitfalls. Take action now to ensure compliance and maintain your eligibility for employment in regulated fields.