4. Park Forest Police Department Private Security Camera Incentive Program

5. 
7. Property/Business location, Please provide the property address where the camera is located: *

   Please provide the property address where the camera is located.

9. Property type:*

   Residence, Business, Nonprofit Organization

11. Location of cameras on exterior of property: *

    1. Front of building
    2. Left side of building (when facing)
    3. Rear of building
    4. Right side of building (when facing)
    5. Other

    *Please note* The Park Forest Police Department will only currently reimburse one (1) front facing security camera per business/residence/non-profit.

12. Camera is angled to record the front of residence

    1. Yes
    2. No

    *Please note* The Park Forest Police Department will only currently reimburse one (1) front facing security camera per business/residence/non-profit.

14. Your name:*
15. Email address:*
16. Phone number:*
18. Agreement:*

    Does the applicant express permission for the Department to have access to recorded video?

    To be eligible for this reimbursement program the applicant must agree to allowing law enforcement to have access to recorded video captured on this device. The collection, dissemination, and use of video by the Park Forest Police Department will be for official law enforcement purposes only. All efforts will be made to ensure the anonymity of the applicant. 

    1. Yes
20. Camera has digital video recording capability*

    Initial*

21. Camera system retains video footage for at least 7 days*

    Initial*

22. Camera is installed facing the street*

    Initial* 

24. Camera is an outdoor surveillance camera and is weatherproof*

    Initial*

25. Camera is not used for the sole purpose of recording private property not owned or leased by the Applicant*

    Initial*

27. Security Camera Information

29. Please choose the appropriate response*

    1. ​​The security camera system was installed by a business with a valid Business License that is engaged in the installation of security systems, the business shall certify the installation of the camera system at the property, including photographic evidence.​​
    2. The security camera system was installed by the property owner, business owner, or another person without a valid Business License that is engaged in the installation of security systems, the Applicant gives permission for the Department to conduct an on-site visit to verify the installation of the security camera system.
31. Camera make and model*
32. Camera serial number*
33. Number of cameras on exterior of property*
35. How many days is the video stored for?*
36. Additional comments:

38. Security camera purchase information

40. Where was the camera purchased?
41. Date of purchase:

    must be within 90 days of application deadline

42. Camera value:*

    The Park Forest Police Department will reimburse up to $200 per residence/business/nonprofit.

44. File upload*

    Please upload image of your Photo ID/State ID/Drivers License: (if you do not have the capability of uploading ID, you will need to be bring a photo ID to the Park Forest Police Department to be eligible for reimbursement, we will be able to make a copy of your ID for you).

45. File upload*

    Please upload image of your receipt: (if you do not have the capability of uploading your receipt, a copy of your receipt will need to be dropped off at the Park Forest Police Department to be eligible for reimbursement).

46. File upload

    Please upload any additional supporting documents:

Leave This Blank:


48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit

* indicates a required field