It calls for your name, address and social security number.
You also need to include the number of residents in your household, and the names of frequent visitors.
And don't forget to list any tattoos or nicknames or gold teeth you might have.
Carol Wallace, a Chicago Housing Authority resident says the "contact cards" that police make her and other residents fill out are an effort to invade their privacy in their own homes.
That's the basis behind a lawsuit Wallace and several other residents filed last month against various members of the Chicago Police Department. Aaron Boyd, Cynthia Bush, and Sirbrenna Summerall are the residents listed in the suit, which was filed in U.S. District Court.
The suit contends residents are being subjected to unlawful searches and seizure of property, racial profiling, false arrest and other violations of constitutional rights. Nearly 200 complaints by residents collected so far say police are conducting unlawful searches of apartments.
Tamara Holder, the attorney representing the complainants, who are residents of the Ickes Homes, says members of the police department have used their badges as a license to barge in when they're not legally allowed.
"They've been telling the residents that since [the residents] live in government housing, [the police] can come in and search at anytime for anything," she said. "We are saying this is a constitutional violation of privacy."
Chicago Police Department spokeswoman Monique Bond said in a phone interview on Tuesday that the contact cards are voluntary.
"Police use the cards as an investigative tool when they have reasonable suspicion to believe a crime is being committed or has been committed," Bond said.
Bond also pointed out that two of the residents listed in the lawsuit have criminal arrest histories.
When Wallace, a 63-year-old resident of CHA's Dearborn Homes, complained about the contact cards in an article in the Chicago Sun-Times last July, she said more than 10 police officers showed up with a search warrant for her home.
"They rushed my door, and told me to stand in the middle of the room," she said. "They said I was selling rocks -- or drugs -- and they tore up my bedroom. It was terrible. They were doing this to frighten me."
Instead, the incident inspired Wallace to speak out.
She called the Rev. Jesse Jackson of the Rainbow PUSH Coalition, hoping he could offer some advice on what she felt was an unlawful intrusion.
Jackson brought attention to the issue earlier this month by spending the night in an Ickes' unit to see firsthand the alleged police abuse.
But one community leader says the neighborhood can't change in one night.
Mary Johns, the editor in chief of the Residents' Journal, recalled when her staff broke the story on the issue of CPD contact cards in June 2007, she said in a phone interview last week.
"After hearing about Ms. Wallace's issue," Johns said, "assistant editor Beauty Turner started her own investigation into complaints about the contact cards at other CHA homes, like the Ickes. This has been going on longer than what you see today."
CHA press secretary Derek Hill had no comment on the issue.
Holder says she's still fielding complaints and hopes to use new testimonies to reach class-action status for the lawsuit.