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PRINTED: 04/09/2019 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 0717 department of?

The printed 0717 form is a tax form related to income tax filings for specific departments, detailing income earned within certain taxation guidelines.

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To fill out the printed 0717, taxpayers should provide accurate income information, relevant deductions, and any other required details as specified in the form instructions.

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The purpose of the printed 0717 is to ensure that taxpayers report their income correctly and comply with the tax regulations set by the department.

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Information that must be reported includes total income, applicable deductions, and other relevant financial details specific to the taxpayer's situation.

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