Get Stax 300 Hr

The Stax 300 Hr form is essential for hospitals seeking a sales tax exemption in Illinois. This guide provides step-by-step instructions to facilitate the online completion of this document.

Follow the steps to successfully complete the Stax 300 Hr online.

1. Click the ‘Get Form’ button to obtain the Stax 300 Hr form and access it in your online editor.
2. Identify the entity by entering the exemption number at the top of the form, providing the name of the hospital or affiliate filing the renewal in line 1.
3. Fill in the street address of the hospital or affiliate in line 2. In line 5, indicate whether the values for services and activities reflect the hospital year or an average of three fiscal years.
4. Provide the fiscal year for the hospital in line 3.
5. Enter the amount of charity care provided by the hospital in line 6, measured at cost.
6. For line 7, input the unreimbursed costs for health services provided to low-income and underserved individuals.
7. In line 8, indicate the total subsidy provided to state or local governments for health care programs.
8. For line 9, enter the total subsidy given to low-income individuals through Illinois health care programs.
9. In line 10, calculate and enter the dual-eligible subsidy based on the hospital's ratio of dual-eligible patients to Medicare patients.
10. Provide the total low-income portion of unreimbursed costs related to government relief in line 11.
11. In line 12, specify any other services or activities not reported above and enter their value.
12. Add the values from lines 6 through 12 for the total on line 13.
13. Enter the total amount of property taxes for all exempt properties on line 14.
14. Sign and date the form in the signature section. Include the printed contact name and ensure the form is notarized before submission.

Complete and submit the Stax 300 Hr form online to ensure your hospital's sales tax exemption.