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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION NUMBER:15520303/01/2016FORM

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Printed 1204 department is the form used by businesses to report their annual financial information to the Department of Revenue.

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All businesses operating in the state are required to file printed 1204 department forms to report their financial information.

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Printed 1204 department forms require businesses to report their total revenue, expenses, net income, and any other relevant financial information.

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