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PRINTED: 09/19/2019 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION

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What is printed 0919 department of?

Printed 0919 is a tax form used by the Department of Revenue for reporting income tax withheld for the state.

Who is required to file printed 0919 department of?

Employers who withhold state income tax from their employees' wages are required to file printed 0919.

How to fill out printed 0919 department of?

To fill out printed 0919, provide the required information such as employer details, employee information, amounts withheld, and any other relevant data as specified in the form instructions.

What is the purpose of printed 0919 department of?

The purpose of printed 0919 is to report the total amount of state income tax withheld from employee wages for a specific period.

What information must be reported on printed 0919 department of?

The information that must be reported includes the employer's details, employee names, Social Security numbers, total wages, and the amount of income tax withheld.

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