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Get IL Hospital Financial Assistance Report

Iling of either its Community Benefits Report as required by the Community Benefits Act or its Worksheet C Part I as required by the Hospital Uninsured Patient Discount Act, a Hospital Financial Assistance Report to the Office of the Attorney General. This form shall be completed and filed with the Office of the Attorney General as described below. Reporting Hospital: Mailing Address: City, State, Zip: Reporting Period: through Taxpayer Number: ••• 1. Attach a copy of each Hospital Finan.

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