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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:15524606/01/2017FORM
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Printed 1125 refers to IRS Form 1125, which is used to report income or expenses for certain types of businesses, particularly related to the Department's requirements.
Businesses that meet specific criteria, including those with certain types of income or expenses that must be reported to the Department, are required to file Form 1125.
To fill out Form 1125, gather all relevant financial information, complete all sections as specified, ensuring accuracy in reporting income and expenses, then submit it as per the Department's guidelines.
The purpose of Form 1125 is to provide the Department with a detailed account of a business's income and expenditures, helping ensure compliance with tax regulations.
Form 1125 must report details like gross receipts, cost of goods sold, and other income or expenses relevant to the business activities.
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