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PRINTED: 06/29/2018 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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Printed 0629 is a specific form used by the Department of Revenue for reporting various tax information in certain jurisdictions.
Individuals or businesses that meet specific income thresholds or criteria set by the Department of Revenue are required to file printed 0629.
To fill out printed 0629, provide your personal or business information, report all applicable income, and complete any required schedules or attachments as indicated in the form instructions.
The purpose of printed 0629 is to report income and calculate tax liability in accordance with state or local tax laws.
Information that must be reported includes gross income, deductions, credits, and any other related tax information as required by the form.
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