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FOR BHF USELL1
2016
STATE OF ILLINOIS
DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
FINANCIAL AND STATISTICAL REPORT (COST REPORT)
FOR LONGER CARE FACILITIES
(FISCAL YEAR 2016)I.DPH License ID Number:
Facility
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What is bria of belleville?
Bria of Belleville is a form used to report certain financial information for the City of Belleville.
Who is required to file bria of belleville?
All businesses operating in the City of Belleville are required to file bria of Belleville.
How to fill out bria of belleville?
To fill out bria of Belleville, businesses must provide detailed financial information as requested on the form.
What is the purpose of bria of belleville?
The purpose of bria of Belleville is to ensure businesses are reporting their financial information accurately for tax and regulatory purposes.
What information must be reported on bria of belleville?
Businesses must report details on their revenue, expenses, and other financial information as requested on the form.
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