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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:
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The get certification statement sample is a document confirming that certain information is accurate and truthful.
Individuals or entities required to provide a certification of accuracy or authenticity.
The get certification statement sample can be filled out by completing the required fields and signing the document.
The purpose of the get certification statement sample is to ensure that information provided is true and accurate.
Information such as name, date, signature, and any relevant details that require certification.
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