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PRINTED: 10/22/2013 FORM APPROVED Division of Public and Behavioral Health STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER: ZETA HOME CARE (X4) ID
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The printed 1022 form approved is a document provided by the IRS for reporting certain income and expenses.
Individuals or businesses who have specific types of income and expenses as outlined by the IRS are required to file the printed 1022 form approved.
To fill out the printed 1022 form approved, you will need to gather all relevant income and expense information and follow the instructions provided by the IRS for completing the form.
The purpose of the printed 1022 form approved is to report specific income and expenses to the IRS for tax purposes.
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