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FOR BHF USELL1
2015
STATE OF ILLINOIS
DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
FINANCIAL AND STATISTICAL REPORT (COST REPORT)
FOR LONGER CARE FACILITIES
(FISCAL YEAR 2015)I.DPH License ID Number:
Facility
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Namediana kieme is a financial disclosure form required to be filed by certain individuals.
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Namediana kieme is required to be filed by public officials, such as government employees, elected officials, and certain individuals in positions of influence.
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Information such as assets, income, investments, debts, and other financial interests must be reported on namediana kieme.
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