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OMB No. 15450047FormReturn of Organization Exempt From Income TaxIDepartment of the Treasury Internal Revenue Service10×01, 2011, and endingALICE PECK DAY MEMORIAL HOSPITALAddress changeling Business
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Start by gathering all the necessary information, such as the full name of the deceased, their date of birth and date of death, their address, and their family members' names and contact information.
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Alice Peck Day Memorial Hospital is a non-profit community hospital located in Lebanon, New Hampshire.
Patients who have received services or treatment at Alice Peck Day Memorial Hospital may be required to submit a memorial form for billing purposes.
Patients can fill out the memorial form either online through the hospital's website or by visiting the billing department in person.
The purpose of the memorial form is to accurately bill patients for services received at Alice Peck Day Memorial Hospital.
The memorial form typically requires personal information, insurance details, and a breakdown of services received.
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