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PRINTED: 09/28/2021 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 0913 is a form used by the Department of Revenue.
Businesses and individuals who meet certain criteria are required to file printed 0913.
Printed 0913 can be filled out online or by mail, following the instructions provided by the Department of Revenue.
The purpose of printed 0913 is to report certain financial information to the Department of Revenue.
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