All requests for a list of visits for income tax purposes must be submitted using this form. Once completed the form must be sent to the address listed on the form.
Please allow 2 to 3 weeks for processing these requests. The information requested will be sent via mail to the address provided on the completed request form.
For inquiries regarding the processing of this form, contact (709) 256-5994.
The Request for dates(s) of visit(s) for Income Tax purposes form can be picked up at Central Health's Financial Services Departments or downloaded by clicking on this link: Request for dates(s) of visit(s) for Income Tax purposes form