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Printed: 12/29/2021 Form Approved OMB No. 09380391Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA

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What is printed 0112 - form?

Printed 0112 form is a tax form used for reporting income and expenses for a specific tax year.

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Individuals or businesses who have income and expenses to report for the tax year.

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You can fill out the printed 0112 form by providing accurate information about your income and expenses in the designated sections.

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The purpose of printed 0112 form is to report income and expenses to the tax authorities for tax assessment purposes.

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You must report all sources of income, deductions, and credits on the printed 0112 form.

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