Illinois Department of Transportation, Milton R. Sees, Secretary Rod R. Blagojevich, Governor
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DIVISION OF TRAFFIC SAFETY

Files below are MS Word Template files. If you do not have Word, MS Word Viewer is available to read these files. See Tips and Tools for a free copy of MS Word Viewer.

For assistance please call the Division of Traffic Safety at (217) 785-2367


Tips - Tools -Troubleshooting

The following forms are related to Highway Safety Grants. Please phone (217) 782-4972 if you have any questions.

File Name Form Title Revised Date
TS 01 Receipt of Equipment  
TS 02 Highway Safety Project Grant Budget Revision Request & Approval 11/05/08
TS 04 On-Site Event Monitoring Report  
TS 06 Highway Safety Project Monitoring/Contract Report  
TS 07 Performance Report for Non-Enforcement Grants   02/07/08
TS 08 Highway Safety Project Agreement, Conditions and Certifications  07/07
TS 08a Highway Safety Project Agreement, Conditions and Certifications   03/11/08
TS 08aa Highway Safety Project Agreement, Conditions and Certifications (no macros)   03/11/08
TS 08b Highway Safety Project Agreement, Conditions and Certifications - Memorial Day  
TS 08c Highway Safety Project Agreement, Conditions and Certifications - Labor Day  
TS 08 TD Highway Safety Project Agreement, Conditions and Certifications - Teen Driving 7/25/08
TS 09 On-Site Project Monitoring Checklist and Report 01/11/08
TS 09-A State Agency Project Monitoring Checklist and Report  
TS 10 Project Monitoring/Contact Report  
TS 10-A State Agency Project Monitoring/Contact Report  
TS 11 Project File Closeout Review  
TS 11-A State Agency Project File Closeout Review 10/02/08
TS 12 State Agency Highway Safety Project Agreement  
TS 13 State Agency Highway Safety Project Request  
TS 20 Highway Safety Project Notification of Change in Highway Safety Project Personnel 11/07/08
TS 20-A State Agency Highway Safety Project Notification of Change in Highway Safety Project Personnel  
TS 21 Verification of Fringe Benefits and Social Security Percentages Paid by Employer  
TS 23 Final Cost Verification and Certification for Highway Safety Project  
TS 24 Claim Processing Memo  
TS 25 Review of Local Agency's Financial Procedures 10/23/07
TS 26 Orientation Meeting Check List 01/14/08
TS 26-A State Agency Orientation Meeting Check List  
TS 28 PI-1 Distribution of Materials  
TS 29 PI-2 Presentation Report  
TS 30 FFY 2009 Local Project Request Review LEL, LAL, Program or Project Coordinator 4/18/08
TS 31 FFY 2009 Local Project Request Highway Safety Planning Committee Pre-Review 5/19/08
TS 32 FY 2010 State Agency Project Request Highway Safety Planning Committee Pre-Review 4/21/08
TS 33 FY 2010 State Agency Project Request Review LEL, Program or Project Coordinator  4/21/08
TS 34 Highway Safety Project Grant Holiday Mobilization Monitoring  
TS 35 Major Equipment Inventory  
TS 36 Major Equipment Inventory Inspection  
TS 100 Alcohol Data Collection Form  
TS 200 Occupant Protection Mobilization Data Collection Form  
TS 200-A Occupant Protection Mobilization Data Collection Form - Daytime Enforcement  
TS 200-B Occupant Protection Mobilization Data Collection Form - Nighttime Enforcement  
TS 201 Boost Illinois Program Quarterly Booster Safety Seat Distribution 11/07/08
TS 202 Boost Illinois Program Quarterly Booster Safety Seat Income Report 11/07/08
TS 203 Monthly Child Safety Seat Income Report 11/07/08
TS 204 Monthly Child Safety Seat Distribution  
TS 205 Speed/IMAGE/MAP Mobilization Data Collection  
TS 206 Injury Prevention Program Monthly Income and Expenditure Report 11/21/08
TS 300 TLEP & LAP Data Collection Form  
TS 301 LAP Tables  
TS 400 SPEED, IMaGE & MAP Data Collection Form  
TS 401 Speed Enforcement Program Speed Survey  
TS 402 Speed Enforcement Program (SEP) Speed-Related Crash Data 9/12/08
TS 403 TLEP Tables  
TS 404 IMAGE Campaign - Driver and Front Seat Passenger Seat Belt Usage Survey  
TS 405 Integrated Mini-Grant Enforcement (IMaGE) Final Report - Crash Data  
TS 406 Roadside Safety Check Data Sheet  
TS 407 Mini-Grant Alcohol Program (MAP) Final Report - Crash Data  
TS 408 Section 408 Project Description  
TS 409 Section 408 Project Update 2/21/08
TS 410 CMV - Speed 4/15/08
TS 500 Highway Safety Project Claim for Reimbursement SPEED, IMaGE, MAP & Mobilizations 10/07
TS 501 TD Highway Safety Project Cost Summary - Operation Teen Safe Driving 7/25/08
TS 502 TD Highway Safety Project - Request for Payment Operation Teen Safe Driving 7/25/08
TS 503 TD Operation Teen Safe Driving Application 9/08/08
TS 504 TD Setting SMART Goals 7/25/08
TS 505 TD Reporting Your Activities - Operation Teen Safe Driving Worksheet & Instructions 8/20/08
TS 506 TD Developing A Timeline 7/25/08
TS 507 TD Safety Belt Use Survey 7/25/08
TS 508 TD Making a Budget 7/25/08
TS 509 TD Request for Project Continuation Payment and Agreement Modification Operation Teen Safe Driving 7/25/08
TS 510 TD Post-Prom Event Prize Spending Summary Operation Teen Safe Driving 7/25/08
TS 511 TD 2008-2009 Operation Teen Safe Driving Calendar & Checklist for High Schools 7/25/08
TS 512 TD Operation Teen Safe Driving Monitoring / Contact Report 9/18/08
TS 600 Highway Safety Project Claim for Reimbursement TLEP, LAP and Non Law Enforcement 11/05/08
TS 600 -Attachment B Claim for Reimbursement Cover Sheet  
TS 600 -Attachment C Payroll Calculation Sheet  
TS 600 -Attachment D Personal Services Time Card  
TS 600 - Attachment E Daily Activity Record  
TS 600 -Attachment F Odometer Log 11/05/08
TS 601 Highway Safety Project Request for Out of State Travel  

The following form is to be used by contractual workers from outside state agencies.
Please phone (217) 524-4040 if you have any questions.

File Name Form Title Revised Date
TS 2300 Contractual Employees Time Report. 10/21/08

The following forms are related to the Cycle Rider Safety Program. Please phone (217)785-1181 if you have any questions.

File Name

Form Title

 Revised Date
TS 700 Illinois Cycle Rider Training Program On-Site Monitoring Report for Classroom  
TS 701 Illinois Cycle Rider Training Program On-Site Monitoring Report for Range  
TS 702 Waiver or Release of Liability 9/30/08
TS 703 Monthly Report  
TS 704 Motorcycle Crash / Incident Report For Student  
TS 705 Cycle Rider Safety Training Program (CRSTP) Reimbursement Claim  
TS 706 Instructor Update Attendance Record  
TS 707 Motorcycle Crash/Incident Report for Instructor  

The following forms are related to Commercial Vehicle Safety. Please phone (217) 785-1181 if you have any questions.

File Name Form Title Revised Date
TS SVI 1187 Application for Official Testing Station Permit  
TS 05 Diesel Emission Requisition Form  
TS 1200 Application for Certified Safety Tester Examination 4/28/08
TS 1985 Report of Returned Certificates of Safety  
TS 1188 Official Testing Station Personal Questionnaire  
TS SVI 1274 Requisition Form  
TS SVI 1241 Report of Lost or Stolen Safety Certificates  
TS SVI 1280 Defective, Mutilated or Voided Certificate of Safety Report  
TS SVI 1165 Bond Form  

The following form is related to Public Information & Education Materials.
Please phone (217) 557-0132 if you have any questions.

File Name Form Title Revised date
TS 2268 Public Information and Educational Materials 08/04/08
TS 2204 User's Survey of Traffic Safety Materials  

The following form is related to Illinois Coroners reporting traffic crash fatalities. Please phone (217) 782-2575 if you have any questions.

File Name Form Title Revised date
TS SR8 State of Illinois Coroner's Report of Deaths Resulting from Motor Vehicle Crashes 02/14/08
TS SR8 Instructions Instructions For the Use of Form TS SR8 02/14/08

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