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FOR OF USELL1 2002STATE OF ILLINOIS DEPARTMENT OF PUBLIC AID FINANCIAL AND STATISTICAL REPORT FOR LONGER CARE FACILITIES (FISCAL YEAR 2002)I.DPH Facility ID Number: Facility Name:0045872II.CERTIFICATION

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Temple Avenue is a form or document that must be filed with the relevant authority.

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The purpose of Temple Avenue is to gather important information from individuals or companies for regulatory purposes.

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On Temple Avenue, you must report details about your income, expenses, and other financial information as required by the authority.

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