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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:0023036II.IMPORTANT

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Rose C is a specific form used for reporting certain types of income and business activities for tax purposes.

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The purpose of Rose C is to capture and report income and expenses related to specific business activities for tax assessment and compliance.

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Information that must be reported on Rose C includes income amounts, types of business activities, deductions taken, and any relevant personal or business identification numbers.

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