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Yes <br />5. If the source of IGT funding is from taxes, please answer the following questions: <br />a. Is the tax a state, county, city, or hospital district tax? <br />County <br />f other, please explain <br />h What entities are taxed? <br />c. Wr <br />d. Wl <br />Jcensed non-public hsopitals in Indian River County <br />A is the tax structure (i.e. property tax, percentage of revenue, assessment, etc.)? <br />>pecial assessment <br />t is the amount or percent or the tax <br />.10% of Net Patient Revenue <br />,. TRUE COPY <br />ERTIFICATION ON LAST PAGE <br />.. SMITH, CLERK <br />e. Does at least 85% of the burden of the tax revenue fall on health care providers as defined in 42 <br />CFR §433.55? (Provide the total tax revenue and the health care provider tax burden) If so, please <br />answer the following questions: <br />Amount <br />otal Tax Burden $ 8,846,336 <br />iealthcare Provider Tax Burden <br />I uu.uu"/o <br />i) Is the tax broad based? A broad based tax can be defined as a tax that is imposed on at least <br />all health care items or services in the class or providers of such items or services furnished by <br />all non -Federal, non-public providers in the State, and is imposed uniformly, pursuant to 42 <br />CFR § 433.68. <br />Yes <br />no, please explain <br />