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IC Indiana Code 31-19-5-14 indicates public notice of purpose and operation of the putative father registry. PRINTED DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE MEDICAID SERVICES STATEMENT OF DEFICIENCIES X1 PROVIDER/SUPPLIER/CLIA AND PLAN OF CORRECTION IDENTIFICATION NUMBER 150088 03/24/2016 FORM APPROVED OMB NO. 2. Interview of employee A1 on 12-30-2015 at 4 35 pm indicated there was no documentation and none was provided prior to exit. See attached document Quality Risk...

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1. To fill out Anderson in 46016, follow these steps:
2. Obtain the Anderson in 46016 form from the relevant authority.
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5. Fill in any additional requested information, such as your social security number or date of birth.
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8. Report any sources of income, including wages, investments, or benefits.
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