8-Hour Security

Signature of Trainee: Date:

CITY STATE

WEIGHT HEIGHT HAIR COLOR EYE COLOR

ZIP CODE

SOCIAL SECURITY NUMBER

HOME STREET ADDRESS

DATE OF BIRTH

TRAINEE: This is your permanent record of training--a duplicate will not be issued. I hereby certify that I have completed the basic training checked below as required by the Illinois Private Detective, Private Alarm, Private Security, Fingerprint Vendor, and Locksmith Act of 2004. NAME (LAST, FIRST, MIDDLE INITIAL)

I hereby certify that the above-named trainee successfully completed the training checked above as required by the Illinois Private Detective, Private Alarm, Private Security, Fingerprint Vendor, and Locksmith Act of 2004. Signature of Instructor: Date:

IMPORTANT NOTICE: Completion of this

form is necessary for consideration for licensure

under 225 ILCS 447/1 et.seq. (Illinois Compiled

Statutes). Disclosure of this information is

VOLUNTARY. However, failure to comply may

result in this form not being processed.

IL486-0486 7/12 (DE)

INSTRUCTOR: This form is to be returned to the trainee after completion. This serves as the trainee's permanent record of completion of 20-hour basic and/or refresher training. Check one of the following that apply to the basic training or refresher training that has been completed by the applicant listed above in compliance with the guidelines outlined in the Illinois Private Detective, Private Alarm, Private Security, Fingerprint Vendor, and Locksmith Act of 2004.

20-Hour Basic Training

Completed Basic Training under Section 15-25 for a Detective Agency

Completed Basic Training under Section 20-20 for an Alarm Contractor Agency

Completed Basic Training under Section 25-20 for a Security Contractor Agency

Completed Basic Training under Section 30-20 for a Locksmith Agency

Completed Basic Training under Section 31-20 for a Fingerprint Vendor

Completed Basic Training under Section 35-45 for a Proprietary Security Force 8-Hour Training Courses

Completed 8-Hour Site-Specific Training under Section 25-20 for a Security Contractor Agency OR

Completed 8-Hour Refresher Training under Section 25-20 for a Security Contractor Agency Certification of Completion of a

Basic Training Course

CITY STATE ZIP CODE

NAME OF INSTRUCTOR

NAME OF ENTITY OFFERING TRAINING

STREET ADDRESS

DATE TRAINING COMPLETED

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