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FOR BHF USELL1
2017
STATE OF ILLINOIS
DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
FINANCIAL AND STATISTICAL REPORT (COST REPORT)
FOR LONGER CARE FACILITIES
(FISCAL YEAR 2017)I.DPH License ID Number:
Facility
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What is 14500 s?
14500 s refers to a specific tax form used for reporting income.
Who is required to file 14500 s?
Individuals or entities with income meeting certain criteria may be required to file a 14500 s form.
How to fill out 14500 s?
To fill out a 14500 s form, one must gather all necessary income information and follow the instructions provided on the form.
What is the purpose of 14500 s?
The purpose of a 14500 s form is to report income to the appropriate tax authorities.
What information must be reported on 14500 s?
Information such as income earned, deductions, and any taxes withheld must be reported on a 14500 s form.
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