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Signature of Applicant Original Signature Date ATTACH A COPY OF YOUR CURRENT ILLINOIS LICENSE IF APPLICABLE. State of Illinois Illinois Department of Public Health HHA Agency Manager Qualification Review Form ALL AGENCIES EXCEPT HOME HEALTH Attachment E-Agency Manager Qualification Review Form If the agency is applying for more than one type of agency complete an additional Attachment E form for each manager. 30 for the requirements for the agency manager. List applicable professional...
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All agencies except home refer to government entities or organizations outside of a person's primary residence.
Individuals or businesses who own or operate multiple agencies outside of their primary residence are required to file all agencies except home.
To fill out all agencies except home, individuals or businesses must gather information about each agency, including their addresses, ownership details, and any income or expenses related to them.
The purpose of filing all agencies except home is to accurately report all properties or businesses owned or operated by an individual or business outside of their primary residence for tax or regulatory purposes.
Information that must be reported on all agencies except home includes the addresses of each agency, ownership details, any income or expenses related to them, and any relevant documentation.
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