Blank Illinois Perc Card Template

The Illinois Permanent Employee Registration Card (PERC) is a necessary credential for individuals seeking employment in specific security-related roles within the state. This card must be renewed every three years, and certain exemptions apply based on existing licenses or employment status. To begin the application process, please fill out the form by clicking the button below.

Article Structure

The Illinois Permanent Employee Registration Card (PERC) form plays a crucial role for individuals seeking employment in the private security sector. This card is essential for unarmed security personnel and must be renewed every three years, with reminders sent via email approximately 90 days before expiration. Before applying, it’s important to understand who is exempt from needing a PERC; for instance, licensed detectives and certain peace officers do not require this card. The application process involves several steps, including completing the form in full, providing a social security number, and paying a non-refundable fee of $55. Additionally, applicants must undergo a security clearance, which includes a criminal background check. This process ensures that individuals meet the necessary requirements to work in security roles. If you’ve previously held a PERC, you cannot apply for a new one unless your original has expired, in which case you should seek a renewal. Understanding these key aspects can help streamline the application process and ensure compliance with Illinois regulations.

Form Sample

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)

⇩ PDF

Document Specifications

Fact Name	Fact Description
Expiration Period	The Illinois PERC expires every three years, with the last expiration date being May 31, 2018.
Renewal Notification	Renewal notices are sent via email approximately 90 days before the expiration date.
Exemptions	Peace officers and certain security personnel at regulated nuclear sites are exempt from needing a PERC.
Application Validity	Submitted applications are valid for three years from the date they are received.
Age Requirement	Applicants must be at least 18 years old to apply for a PERC in an unarmed capacity.
Registration Fee	A non-refundable registration fee of $55.00 must be submitted with the application.
Security Clearance	Security clearance is required before a PERC can be issued. Fingerprinting is part of this process.
Governing Law	The PERC is governed by 225 ILCS 447/1 et. seq. (Illinois Compiled Statutes).

Steps to Filling Out Illinois Perc Card

To successfully complete the Illinois Permanent Employee Registration Card (PERC) application form, follow the steps outlined below. Ensuring that each section is filled out accurately will help prevent any delays in processing your application.

Complete the application in its entirety. Ensure all fields are filled out clearly.
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 for the application.
Prepare a non-refundable registration fee of $55.00, made payable to the Department of Financial and Professional Regulation.
Gather the necessary security clearance documents as specified in the application instructions.
Submit the completed application, the copy of your 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 be processed, and you will receive further information regarding your PERC status. Ensure that all documents are correctly submitted to avoid any delays.

More About Illinois Perc Card

What is the Illinois PERC Card and who needs it?

The Illinois Permanent Employee Registration Card (PERC) is required for individuals working in certain security-related positions, including unarmed security guards. If you hold a valid Illinois detective, security contractor, alarm contractor, or locksmith license, you do not need a PERC to work for a licensed agency. The PERC is valid for three years from the date of receipt and must be renewed before expiration.

How do I apply for a PERC Card?

To apply for a PERC Card, complete the application in its entirety. Ensure that you are at least 18 years old and provide your U.S. social security number, as it is mandatory. Submit a non-refundable registration fee of $55.00, along with the appropriate security clearance documents and a copy of your electronic fingerprint receipt. Send all materials to the Illinois Department of Financial and Professional Regulation at the specified address.

What if my PERC Card has expired?

If your PERC has expired, you cannot apply for a new card. Instead, contact the Division's Call Center at 1-800-560-6420 to request a renewal. Be sure to indicate any change of address during this process. Renewal notices are typically sent via email approximately 90 days prior to the expiration date.

Are there exemptions from needing a PERC Card?

Yes, certain individuals are exempt from needing a PERC. Peace officers, as defined in the relevant Illinois statutes, do not require a PERC. Additionally, unarmed security guards employed at regulated nuclear facilities who have completed the necessary background screening and training are also exempt. However, the employing agency remains responsible for any peace officer employed under this exemption.

What happens if I have a criminal record?

A criminal conviction does not automatically disqualify you from obtaining a PERC. However, you must disclose any convictions, excluding minor traffic offenses, on your application. Attach a personal statement and certified court records regarding the conviction. It’s important to be transparent, as failure to disclose required information can lead to processing delays or denial of your application.

How can I check the status of my PERC application?

If you have submitted an application within the past three years but did not complete the process, do not submit another application. Instead, contact the Division's Call Center at 1-800-560-6420 to inquire about the status of your application. This will help avoid unnecessary complications and ensure your application is processed efficiently.

Common mistakes

Incomplete Application: Failing to fill out all sections of the application will result in it being returned.
Incorrect Age: Applicants must be at least 18 years old. Submitting an application with an incorrect age will lead to rejection.
Missing Social Security Number: Not providing a U.S. social security number when required can cause processing delays.
Improper Payment: Submitting a payment that is not the required $55.00 or not making it payable to the correct entity will result in non-processing of the application.
Neglecting Security Clearance: Failing to submit the necessary security clearance documents will delay the issuance of the PERC.
Address Changes: Not indicating any change of address on renewal applications can lead to missed communications.
Duplicate Applications: Submitting a new application within three years of a prior application that was not completed can cause confusion and delays.
Ignoring Criminal Background Questions: Failing to answer questions regarding criminal history truthfully may result in denial of the application.

Documents used along the form

When applying for a Permanent Employee Registration Card (PERC) in Illinois, several other forms and documents may be required or helpful to complete the process. Here’s a list of commonly used documents that accompany the PERC application.

Application for Permanent Employee Registration Card: This is the main form that needs to be completed to apply for the PERC. It requires personal information, including your social security number, and must be submitted with a non-refundable fee.
Fingerprint Vendor Receipt: After undergoing a criminal background check, you will receive a receipt from the fingerprint vendor. This document must be submitted with your PERC application.
Identity Verification Certifying Statement: This form is used if you are unable to get fingerprinted through a licensed vendor in Illinois. It verifies your identity and must be completed and signed by a police department.
VE-PEC Form: This form is for applicants who are retired peace officers and wish to waive the security clearance requirement. It verifies your retirement status and must be submitted with your application.
Personal Statement for Criminal Conviction: If you have any criminal convictions, you must attach a personal statement explaining the circumstances, along with certified copies of court records.
Explanation for Discharge from Armed Services: If you were discharged from the military other than honorably, provide an explanation with your application.
Medical Statement: If you have any medical conditions that affect your ability to perform your job, you may need to submit a detailed statement regarding your condition.
Child Support Compliance Certification: Applicants must certify that they are not more than 30 days delinquent in child support payments, as this can affect your application.

Ensure that you gather all necessary documents before submitting your PERC application to avoid delays in processing. Each document plays a vital role in confirming your eligibility and compliance with Illinois regulations.

Similar forms

The Illinois PERC Card form shares similarities with the application for a Firearm Owner's Identification (FOID) Card. Both documents require applicants to disclose personal information, including their social security number, date of birth, and residence address. Additionally, both applications necessitate a background check, which is crucial for ensuring the safety of the community. The renewal process for each card also follows a similar timeline, typically requiring renewal every few years, which helps maintain updated records on the applicants.

Another document akin to the Illinois PERC Card form is the application for a Private Security License. This application, like the PERC Card form, mandates that applicants meet specific eligibility criteria, such as age and background checks. Both documents also require the submission of a non-refundable fee and supporting documents to verify the applicant’s identity and qualifications. The focus on public safety and regulatory compliance underscores the shared purpose of these forms in the security industry.

The application for a Certified Nursing Assistant (CNA) license in Illinois is also comparable to the PERC Card form. Both applications require a thorough background check to ensure the safety of vulnerable populations. Additionally, they necessitate the submission of a fee and completion of specific training or educational requirements. This emphasis on background checks and training reflects a commitment to maintaining high standards within their respective professions.

Similar to the PERC Card application, the application for a Real Estate License in Illinois requires detailed personal information and a criminal background check. Both processes include a non-refundable fee and the need for applicants to affirm their qualifications. The renewal requirements for both licenses are also structured to ensure that professionals remain compliant with state regulations and standards.

The application for a Commercial Driver's License (CDL) shares characteristics with the Illinois PERC Card form. Both documents require applicants to provide personal identification details and undergo a background check. The need for training and testing in both applications ensures that individuals are adequately prepared for their respective roles. Furthermore, both licenses have specific renewal timelines, reinforcing the importance of ongoing compliance with state regulations.

The Illinois Liquor License application is another document that resembles the PERC Card form. Both applications require detailed personal and business information, as well as a background check to assess the suitability of the applicant. Each application also necessitates the payment of a fee and adherence to local regulations, emphasizing the importance of responsible management in both fields.

The application for a Cosmetology License in Illinois is similar to the PERC Card form in that both require proof of training and completion of a background check. Each application also mandates the submission of personal information and a fee. This parallel highlights the importance of regulatory oversight in ensuring that professionals in both industries meet established standards for practice.

The application for a Massage Therapy License in Illinois shares similarities with the PERC Card form. Both require applicants to provide personal information, undergo background checks, and submit proof of training or education. Additionally, both applications include a fee structure and renewal process, reflecting the ongoing need for regulatory compliance in both fields.

The application for a Veterinary Technician License is also akin to the Illinois PERC Card form. Both documents require applicants to disclose personal information and undergo a background check. The necessity for proof of training or education, as well as the payment of a fee, further aligns these applications. Both licenses emphasize the importance of maintaining high standards in their respective professions.

Lastly, the application for a Pharmacy Technician License in Illinois is similar to the PERC Card form. Both require applicants to provide personal information and submit to a background check. The fee structure and renewal process for each application are also aligned, underscoring the importance of regulatory compliance in ensuring public safety and professional accountability in both fields.

Dos and Don'ts

When filling out the Illinois PERC Card form, it's important to follow certain guidelines to ensure your application is processed smoothly. Here are ten things to keep in mind:

Do complete the application in its entirety. An incomplete form may be returned.
Do provide your U.S. social security number if you have one. This is mandatory.
Do submit the non-refundable registration fee of $55.00 with your application.
Do include the appropriate security clearance documents as required.
Do ensure that your application is sent to the correct address: Illinois Department of Financial and Professional Regulation.

Don't use a P.O. Box for your home address. A physical address is required.
Don't submit another application if you have already applied within the past three years without completing the process.
Don't forget to attach any necessary explanations if you answer "yes" to certain questions about your background.
Don't ignore the fingerprinting requirement. You must submit evidence of fingerprint processing.
Don't assume that a previous PERC allows you to apply for a new one if your original card has expired. Contact the Division for renewal instructions.

Misconceptions

Misconception 1: A PERC is always required for security work.

Many believe that anyone working in security must have a PERC. However, if you hold a valid Illinois detective, security contractor, alarm contractor, or locksmith license, you do not need a PERC to work for a licensed agency.

Misconception 2: The PERC is valid indefinitely.

Some individuals think that once they obtain a PERC, it lasts forever. In reality, the PERC expires every three years. Renewal is necessary to maintain your eligibility to work.

Misconception 3: You can apply for a new PERC if your original one has expired.

It is a common misunderstanding that individuals can simply reapply for a new PERC if their original card has expired. Instead, you must renew your existing PERC, as applying for a new one is not permitted.

Misconception 4: Fingerprinting is optional for the application.

Some applicants think that fingerprinting is not required. However, a criminal background check through fingerprinting is mandatory for obtaining a PERC. This step is crucial for security clearance.

Misconception 5: You can submit an incomplete application.

Many assume that submitting an incomplete application is acceptable. In fact, any application that is incomplete or illegible will be returned. It is essential to complete all sections accurately to avoid delays.

Key takeaways

Key Takeaways for Completing the Illinois PERC Card Form:

Ensure that you complete the application fully. An incomplete application will be returned, delaying your registration process.
Be aware of the mandatory $55 non-refundable registration fee. This fee must accompany your application to avoid processing delays.
Understand that your application is valid for three years. If you have previously applied but did not complete the process, do not submit a new application; instead, check the status of your existing application.
Security clearance is essential. Permanent Employee Registration Cards will not be issued until the security clearance process is completed, including fingerprinting within 60 days of application submission.