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					                                                                                                      STEP Mobilizations
                                                                                                      Data Collection Form


             PLEASE RETURN THIS FORM TO OUR OFFICE VIA E-MAIL (trafficsafetyreports@dot.il.gov)
         OR FAX (217-558-0141) WITHIN TWO WEEKS OF COMPLETING YOUR ENFORCEMENT ACTIVITIES.
                                PLEASE KEEP THE ORIGINAL FOR YOUR FILES.

    REFER TO THE LINK AT http://www.trafficsafetygrantsillinois.org/Grants_2011.asp#STEP FOR INSTRUCTIONS
              AND EXAMPLES ON PROPERLY COMPLETING YOUR DATA COLLECTION FORM.
   FOR FURTHER ASSISTANCE PLEASE CONTACT THE EVALUATION UNIT AT (217) 782-1805 or (217) 785-3041.

                   ** THIS FORM MUST BE SUBMITTED BEFORE YOUR CLAIM FOR REIMBURSEMENT. **


Section I: All Projects
Please indicate the campaign you are reporting data for:

    Thanksgiving Campaign                         Christmas/New Years Campaign                   Super Bowl Campaign
    St. Patrick’s Day Campaign                    Cinco de Mayo Campaign                         Memorial Day Campaign
    4th of July Campaign                          Labor Day Campaign
    Other:

Dates Enforcement Conducted:                           / /                 To                 / /
                                                  Month / Day / Year                    Month / Day / Year
Reporting agency:                                                                      Project number:
Name of person submitting this report:
Phone:                                                      E-mail address:

Section II: Alcohol Mobilization Campaigns Only
Alcohol-Related Activities Completed For This Campaign:

Total project officer-hours worked by this agency during the campaign:
                      Total Hours Worked:                                             hours
                      Specifically on Roadside Safety Checks:                         hours
                      Specifically on Saturation Patrols:                             hours
                      DUI Processing Hours:                                           hours
                      Actual Patrol:                                                  hours

Number of Vehicles Stopped:                            (N/A for Roadside Safety Checks)

Number of enforcement details conducted: (indicate the number conducted for each type of detail)
                      Number of Details Conducted:
                                                     Joint with Local
                           Stand Alone                                          Joint with ISP
                                                         Agency                                       Saturation Patrols
                        Roadside Safety Check      Roadside Safety Check      Roadside Safety Check




Printed 8/7/2012                                            Page 1 of 3                                      TS 205 (Rev. 09/09/10)
Seat Belt Enforcement Activities Completed For This Campaign:

Section III: Occupant Protection Mobilization Campaigns Only
DAYTIME Seat Belt and Speed Enforcement Activities (6AM – 11PM):
Total project officer hours worked by this agency during the campaign specifically on Safety Belt Enforcement:

              Total Hours Worked:                                                       hours
              Specifically on Daytime Safety Belt Enforcement Zones:                    hours

              Specifically on Daytime Saturation Patrols:                               hours

Number of enforcement details conducted:
(indicate the number conducted throughout the specified campaign for each type of detail)
Number of Safety Belt                                                   Number of Saturation
Enforcement Zones Conducted:                                            Patrols Conducted:

Number of Vehicles Stopped:


Section IV: Occupant Protection Mobilization Campaigns Only
NIGHT TIME Seat Belt and Speed Enforcement Activities (11PM – 6AM):
Total project officer hours worked by this agency during the campaign specifically on Safety Belt Enforcement:

              Total Hours Worked:                                                       hours
              Specifically on Night time Safety Belt Enforcement Zones:                 hours

              Specifically on Night time Saturation Patrols:                            hours

Number of enforcement details conducted:
(indicate the number conducted throughout the specified campaign for each type of detail)
Number of Safety Belt                                                   Number of Saturation
Enforcement Zones Conducted:                                            Patrols Conducted:

Number of Vehicles Stopped:


Section V: All Projects
Total number of specific enforcement actions taken this reporting period:
List below the total number of citations written/enforcement actions taken during the daytime and night time for this
campaign. Daytime is 6:00am – 11:00pm and Night time is 11:00pm – 6:00am.

                                                                                                  Stolen
                                 Safety Belt          Child Safety                                                  Fugitives
         DUI Arrests                                                      Felony Arrests         Vehicles
                                  Citations            Citations                                                  Apprehended
                                                                                                Recovered
        Day          Night      Day       Night       Day       Night      Day      Night   Day       Night        Day      Night




        Suspended /
                                  Uninsured
         Revoked                                       Speeding         Reckless Driving    Drug Arrests              Other
                                  Motorists
         Licenses
       Day          Night       Day       Night       Day       Night      Day      Night   Day       Night        Day      Night




Printed 8/7/2012                                         Page 2 of 3                                        TS 205 (Rev. 09/09/10)
Media Efforts:
List the number of media efforts for the campaign specified above.

                                                                                                                        Press
         Announcements signs,         Banners        Posters / Fliers      Presentations       Press
                                                                                                                      Releases
             marquees, etc.           Displayed       Distributed             Given         Conferences
                                                                                                                       Issued



                                     Public Access    Radio News             TV News           Web
          Print News Stories                                                                                            Other
                                      Messages          Stories               Stories      Announcement




DUI Arrests: BAC levels

    1.             2.          3.          4.        5.              6.         7.         8.            9.              10.

    11.            12.         13.         14.       15.             16.        17.        18.           19.             20.

    21.            22.         23.         24.       25.             26.        27.        28.           29.             30.

    31.            32.         33.         34.       35.             36.        37.        38.           39.             40.



Zero Tolerance: BAC levels

    1.             2.          3.          4.        5.              6.         7.         8.            9.              10.



Total DUI Processing Time:

Regular Non-Overtime Patrol:
                                     Other Moving                          Other Alcohol
              Speeding                                     DUI                                  Safety Belt        Child Restraint
                                      Violations                             Related




                                     Written Warnings:

                                      Safety Belt    Child Restraint           Total



Additional Comments/Notes:




Printed 8/7/2012                                       Page 3 of 3                                            TS 205 (Rev. 09/09/10)

				
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