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PRINTED: 10/24/2019 FORM APPROVEDState of GA, Healthcare Facility Regulation Division STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:025R0033(X2)

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What is 025-r-0033?

025-r-0033 is a specific form used for reporting certain financial or regulatory information, typically associated with business or tax purposes.

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The purpose of 025-r-0033 is to collect essential data for regulatory oversight or tax assessment, ensuring compliance with applicable laws.

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The form typically requires information such as financial statements, personal identification details, and any relevant transactions or activities.

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