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FOR BHF USELL1
2006
STATE OF ILLINOIS
DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
FINANCIAL AND STATISTICAL REPORT FOR
LONGER CARE FACILITIES
(FISCAL YEAR 2006)I.DPH Facility ID Number:
Facility
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To fill out 2136 Windish Drive, follow these steps:
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Start by writing your full name in the designated space on the form.
03
Next, provide your contact information, including your phone number and email address.
04
Indicate whether you are the owner or tenant of the property.
05
If you are a tenant, provide the name of the landlord or property owner.
06
Fill in the date when you started residing at 2136 Windish Drive.
07
Specify the type of residency, such as renting, leasing, or owning.
08
If you are renting, provide the monthly rental amount. If you are an owner, skip this step.
09
Provide any additional information or comments related to your occupancy at 2136 Windish Drive.
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Finally, sign and date the form to certify the accuracy of the information provided.
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What is 2136 windish drive?
2136 Windish Drive is the address/location.
Who is required to file 2136 windish drive?
The individuals or entities with ownership or interest in the property at 2136 Windish Drive are required to file.
How to fill out 2136 windish drive?
To fill out 2136 Windish Drive, you need to provide accurate information about the property and any relevant details as requested.
What is the purpose of 2136 windish drive?
The purpose of 2136 Windish Drive form is to report information about the property located at that address.
What information must be reported on 2136 windish drive?
The information that must be reported on 2136 Windish Drive includes details about the property ownership, any improvements or changes made to the property, and other relevant information.
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