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FOR OF USELL1
2003STATE OF ILLINOIS
DEPARTMENT OF PUBLIC AID
FINANCIAL AND STATISTICAL REPORT FOR
LONGER CARE FACILITIES
(FISCAL YEAR 2003)I.DPH Facility ID Number:
Facility Name:0036020II.CERTIFICATION
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What is heritage square-0018176-ohf?
Heritage Square-0018176-OHF is a tax form used to report heritage square expenses for a specific property.
Who is required to file heritage square-0018176-ohf?
Property owners or managers who incur heritage square expenses for a property are required to file Heritage Square-0018176-OHF.
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