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FOR BHF USE LL1 2012 STATE OF ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES FINANCIAL AND STATISTICAL REPORT (COST REPORT) FOR LONGER CARE FACILITIES (FISCAL YEAR 2012) I. DPH License ID Number:
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Individuals or households applying for financial assistance or programs provided by the HFS (Health and Family Services) may need to fill out this form. It is specific to the state of Illinois (IL), as indicated by the "il478-2471" in the form's title.
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hfs 3745 n-4-99 il478-2471 is a form used for reporting certain information to the relevant authorities.
Individuals or entities who meet certain criteria are required to file hfs 3745 n-4-99 il478-2471.
hfs 3745 n-4-99 il478-2471 can be filled out by providing the requested information in the designated fields on the form.
The purpose of hfs 3745 n-4-99 il478-2471 is to gather specific information for regulatory or compliance purposes.
hfs 3745 n-4-99 il478-2471 requires the reporting of certain details such as income, expenses, assets, or other relevant data.
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