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PRINTED: 03/15/2017 FORM APPROVEDDivision of Health Service Regulation STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:(X2) MULTIPLE CONSTRUCTION A.
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Printed 0309 is the form used by the Department of Treasury to report certain information.
Any individual or entity that meets the criteria set by the Department of Treasury is required to file printed 0309.
Printed 0309 can be filled out either electronically or by hand, following the instructions provided by the Department of Treasury.
The purpose of printed 0309 is to collect specific information for tax or regulatory purposes.
Printed 0309 requires reporting of information such as income, expenses, and other financial details.
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