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FOR BHF USELL1
2022STATE OF ILLINOIS
DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
FINANCIAL AND STATISTICAL REPORT (COST REPORT)
FOR LONGER CARE FACILITIES
(FISCAL YEAR 2022)
I.DPH License ID Number:
Facility
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What is clair-davis?
Clair-davis is a reporting form that is typically used for declaring certain financial or asset information as required by governmental regulations.
Who is required to file clair-davis?
Individuals and entities that meet specific criteria set forth by the regulatory authority are required to file clair-davis.
How to fill out clair-davis?
To fill out clair-davis, one must provide accurate information as requested in the form, including personal or organizational details and financial data.
What is the purpose of clair-davis?
The purpose of clair-davis is to ensure compliance with financial reporting regulations and to provide transparency regarding financial assets.
What information must be reported on clair-davis?
Information that must be reported on clair-davis typically includes income, assets, liabilities, and any relevant financial transactions.
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