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PRINTED: 08/04/2022 FORM APPROVED Indiana State Department of HealthSTATEMENT OF DEFICIENCIES AND PLAN OF CORRECTIONS(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER: 15C0001095(X2) MULTIPLE CONSTRUCTION(X3)
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Printed 0804 Indiana State is a form used for reporting state taxes in Indiana.
All individuals or businesses that have tax obligations in Indiana are required to file printed 0804 Indiana State.
Printed 0804 Indiana State can be filled out manually or electronically, following the instructions provided on the form.
The purpose of printed 0804 Indiana State is to report and pay state taxes to the Indiana Department of Revenue.
Information such as income, deductions, credits, and tax due must be reported on printed 0804 Indiana State.
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