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01/30/2014 13 : 38 Image# 14960290967PAGE 1 / 122REPORT OF RECEIPTS AND DISBURSEMENTS FEC FORM 3 1. For An Authorized Committeeman OF COMMITTEE (in full)Office Use OnlyExample: If typing, type over
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House Health & Social is a form or report that collects data related to the health and social services provided by a household.
Households or individuals who provide health and social services are required to file the house health & social report.
House health & social can be filled out online or on paper by providing information about the health and social services provided.
The purpose of house health & social is to collect data on the health and social services provided by households for analysis and planning purposes.
Information such as types of health services provided, number of individuals served, and social service programs offered must be reported on house health & social.
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