Form Il488 2261 PDF Details

Form IL488 2261 is an important form that needs to be filled out when a taxpayer wants to make an Illinois income tax withholding payment. This form can be filled out either online or manually, and the instructions for doing so are provided on the website. The deadline for filing this form is always the last day of the month following the month in which the withholding payment was made. Failing to submit this form on time may result in penalties and interest charges. So make sure you take care of it as soon as possible!

QuestionAnswer
Form NameForm Il488 2261
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesRehabilitation, Certification, certify, dhs timesheet

Form Preview Example

State of Illinois

Department of Human Services - Division of Rehabilitation Services

Home Services Program Travel Time Sheet

Individual Provider Name:

 

 

 

 

 

 

 

Santrax ID:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FROM CUSTOMER

 

 

TO CUSTOMER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

 

Name (Last, First)

 

Case #

Time (AM/PM)

Name (Last, First)

 

 

Case #

 

Time (AM/PM) Travel (minutes)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Travel (minutes):

INDIVIDUAL PROVIDER CERTIFICATION

I certify that the above information is true and in accordance with the Home Services Program Travel Agreement. I understand that falsification of any information submitted on this form could lead to criminal prosecution.

Individual Provider Signature:

Date:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IL488-2261 (N-12-14) Home Services Program Travel Time Sheet Printed by the Authority of the State of Illinois -0- copies

 

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How to Edit Form Il488 2261 Online for Free

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Pay close attention while filling out this pdf. Ensure every blank is filled in properly.

1. Begin completing the Illinois with a selection of essential fields. Collect all of the necessary information and be sure there is nothing omitted!

Part # 1 of filling in Santrax

2. Now that the previous segment is done, you'll want to insert the essential specifics in Individual Provider Certification, Individual Provider Signature, Date, IL N Home Services Program Travel, Page, and Total Travel minutes so you're able to go further.

Stage no. 2 of filling in Santrax

Regarding Page and IL N Home Services Program Travel, ensure you get them right in this current part. Both these are certainly the most important ones in this page.

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