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FOR BHF USELL2Supportive Living Facility2013STATE OF ILLINOIS DEPARTMENT OF HEALTHCARE & FAMILY SERVICES COST REPORT FOR SUPPORTIVE LIVING FACILITIES (FISCAL YEAR 2013) I. Facility ID Number: Facility
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Declaration of preparer oformr is a form that needs to be filled out by the individual who prepared a particular form or document.
The person who prepared the form or document is required to file the declaration of preparer oformr.
To fill out the declaration of preparer oformr, the preparer needs to provide their name, contact information, and sign the form to certify the accuracy of the information.
The purpose of the declaration of preparer oformr is to ensure accountability and accuracy in the preparation of forms and documents.
The declaration of preparer oformr must include the preparer's name, contact information, and signature.
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