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PRINTED: 04/27/2018 FORM APPROVEDDivision of Health Service Regulation STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTION(X2) MULTIPLE CONSTRUCTIONIDENTIFICATION NUMBER:COMPLETED.
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The printed 0427 form approved is a tax form used for reporting certain information to the tax authorities.
All individuals or entities meeting the criteria set by the tax authorities are required to file the printed 0427 form approved.
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