Form Hfs 3806H PDF Details

Form Hfs 3806H is an important document used by the State of California in order to assess a taxpayer's liability for sales and use taxes. This form is typically filled out by businesses that sell goods or services in California. It is also used to claim tax exemptions or exclusions. Anyone who needs to fill out Form Hfs 3806H should be familiar with its contents and how to complete it correctly. Here, we will discuss what information is required on the form, and provide some tips on how to accurately complete it.

Form NameForm Hfs 3806H
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
Other nameshfs3806h hfs illinois change of address form

Form Preview Example

State of Illinois

Department of Healthcare and Family Services


You have the right to ask the Illinois Department of Healthcare and Family Services (Agency) to amend your personal health information that it has.

The Agency does not have to agree to your request if the personal health information it has about you is accurate and complete, or was not created by the Agency, or is not part of a designated record set, or is not available for you to see.

The Agency is required to tell you within 60 days after it receives your request if it will agree to your request or if it needs more time to respond to your request.

My name:


Date of birth:

I request that the Agency amend my personal health information in this way:

This is the reason why I am asking the Agency to amend my personal health information


Send this Personal Representative

If you have any questions, contact the Privacy

Designation or Revocation to:

Office at the address to the left, or the phone


number below. The call is free.

Privacy Officer


Healthcare and Family Services

Toll-free telephone: 1-800-226-0768

P.O. Box 19159

(Health Benefits Hotline)

Springfield, Illinois 62794-9159

Toll-free for persons using a TTY:



Fax: 1-217-524-2397



e-mail address:

HFS 3806H (R-6-09)

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Completing this PDF will require attentiveness. Make sure that all required blank fields are done properly.

1. It's essential to fill out the Form Hfs 3806H properly, therefore pay close attention when filling out the segments containing these blank fields:

Form Hfs 3806H writing process explained (portion 1)

2. Just after completing this part, go to the subsequent stage and enter the necessary details in these blanks - Send this Personal Representative, If you have any questions contact, and HFS H R.

A way to fill in Form Hfs 3806H step 2

It's very easy to make a mistake when filling in the Send this Personal Representative, for that reason make sure that you reread it prior to when you submit it.

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