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PRINTED: 12/04/2018 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 1204 is a tax form used by the Department of Revenue for reporting certain types of income or withholding.
Individuals or businesses that have specific income types that are subject to withholding or reporting requirements must file the printed 1204.
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The purpose of printed 1204 is to ensure proper reporting of income and withholding to the tax authorities, facilitating accurate tax assessments.
The printed 1204 requires information such as name, identification number, types of income, amounts earned, and any taxes withheld.
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