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PRINTED: 07/24/2020 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 0724 refers to a specific form used by the Department of Revenue for tax reporting purposes in certain jurisdictions.
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Individuals or entities that have specific tax obligations as defined by the Department of Revenue are required to file printed 0724.
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Printed 0724 requires reporting of income figures, deductions, tax credits, and any other relevant financial data as specified by the form.
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