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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:15537508/28/2015FORM
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Printed 0828 is a form used by the Department of Revenue or a similar authority to report specific tax or financial information.
Individuals or entities that meet certain income thresholds or engage in specific types of financial activities as defined by the governing tax authority are required to file the printed 0828.
To fill out printed 0828, provide accurate personal or business information, report income and expenses as required, and follow the instructions outlined in the form.
The purpose of printed 0828 is to ensure compliance with tax laws by reporting required financial information to the relevant tax authority.
Information such as total income, deductions, credits, and other financial details as specified by the form must be reported.
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