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Do Not Staple FormCOMMONWEALTH OF KENTUCKY CABINET FOR HEALTH AND FAMILY SERVICES OFFICE OF HEALTH POLICY CERTIFICATE OF NEEDS ix Month Progress Reportage AND EXACT LOCATION OF FACILITY/PROGRAM/SERVICE:CERTIFICATE
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It is a form used to report important information without stapling any documents.
All individuals or businesses required to report specific information.
Fill out the form by providing accurate information in the designated fields.
The purpose is to report certain information in a clear and organized manner.
Details such as name, address, and relevant data must be reported.
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