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Get the free 06/13/2022 form approved - NC DHHS

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PRINTED: 06/01/2022 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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The 0613 form is a document approved by the IRS for reporting certain types of income.
Individuals or entities who received income that falls under the reporting requirements outlined in the form instructions.
The form can be filled out manually or electronically following the instructions provided by the IRS.
The purpose of the form is to report specific types of income to the IRS for tax purposes.
The form typically requires the reporting of income amounts, source of income, and taxpayer identification information.
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