7:150-AP, E Record of Agency and Law Enforcement Requests

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105 ILCS 5/22-105, added by P.A. 104-288, eff. 1-1-26, places restrictions on government agency and law enforcement authority access to district property, in particular for requests related to citizenship or immigration status. Use this form to document all interactions with law enforcement agents while they are on the District’s premises, as required by 105 ILCS 5/22-105(c)(4)(B), added by P.A. 104-288, eff. 1-1-26. An authorized administrator or the board attorney must review law enforcement requests to enter a school or school facility, including judicial warrants, nonjudicial warrants, and subpoenas. 105 ILCS 5/22-105(c)(4)(A), added by P.A. 104-288, eff. 1-1-26. This form also documents that review. Consult the board attorney regarding the use and maintenance of this form and marking of any attorney-client privileged information.

To be completed by District staff member:

Name of District Staff (Please print)

Title of District Staff Member

Name of District or School Building


Name of Law Enforcement Agent(s) (Please print)	Name of Agency or Law Enforcement Unit


Contact Name	Contact Number

Badge Number or Identification Number (Handwritten only, no photocopies)	Title of Law Enforcement Agent

School Visit Location	Date and Time of Visit

Authorization Presented by the Law Enforcement Agent (Make photocopies and attach to form):

__ Warrant

__ Subpoena

__ Exigent Circumstances (Please be specific): ______________________________________________________________________________________________________

______________________________________________________________________________________________________

__ Other (Please be specific): __________________________________________________________________________ ______________________________________________________________________________________________________

______________________________________________________________________________________________________

Describe the Request from the Law Enforcement Agent to access the above-listed school or District office:

Request to access the school or District office for the following reason(s):

__ To obtain student or employment records.

__ To question a student or employee.

__ To take a student or employee into custody.

__ Other (Please be specific): ___________________________________________________________________________________________________________________

___________________________________________________________________________________________________________________

The following is to be completed by the District Superintendent, Building Principal or designee only:

Name of Superintendent, Building Principal or designee (Please print)

Name of District Office or School Building

Name of Board Attorney Contacted, if any (Please print)

___ Permission Granted ___ Permission Denied


Date			Signature (Superintendent, Building Principal, or designee)

Access Granted to the following (Please be specific):

Visit Supervision (To be completed by the staff member monitoring or accompanying the law enforcement agent)

Supervisor’s Name (Please print)

Visitor Time In ________________ Visitor Time Out _______________

Date

Supervisor’s Signature

To be completed by District staff member:

Name of District Staff (Please print)

Title of District Staff Member

Name of District or School Building


Name of Law Enforcement Agent(s) (Please print)	Name of Agency or Law Enforcement Unit


Contact Name	Contact Number

Badge Number or Identification Number (Handwritten only, no photocopies)	Title of Law Enforcement Agent

School Visit Location	Date and Time of Visit

Authorization Presented by the Law Enforcement Agent (Make photocopies and attach to form):

__ Warrant

__ Subpoena

__ Exigent Circumstances (Please be specific): ______________________________________________________________________________________________________

______________________________________________________________________________________________________

Describe the Request from the Law Enforcement Agent to access the above-listed school or District office:

Request to access the school or District office for the following reason(s):

__ To obtain student or employment records.

__ To question a student or employee.

__ To take a student or employee into custody.

__ Other (Please be specific): ___________________________________________________________________________________________________________________

___________________________________________________________________________________________________________________

The following is to be completed by the District Superintendent, Building Principal or designee only:

Name of Superintendent, Building Principal or designee (Please print)

Name of District Office or School Building

Name of Board Attorney Contacted, if any (Please print)

___ Permission Granted ___ Permission Denied


Date			Signature (Superintendent, Building Principal, or designee)

Access Granted to the following(Please be specific):

Visit Supervision(To be completed by the staff member monitoring or accompanying the law enforcement agent)

Supervisor’s Name (Please print)

Visitor Time In ________________ Visitor Time Out _______________

Date

Supervisor’s Signature