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PRINTED: 06/06/2022 FORM APPROVEDDivision of Health Service Regulation STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:STREET ADDRESS, CITY, STATE,

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What is reviewed and acknowledged km?

Reviewed and acknowledged km refers to kilometers traveled that have been verified and confirmed by both parties involved.

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Individuals or businesses that need to report accurate travel distances for tax or reimbursement purposes are required to file reviewed and acknowledged km.

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Reviewed and acknowledged km should be filled out by recording the starting and ending locations of a trip, as well as the total distance traveled in kilometers.

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The purpose of reviewed and acknowledged km is to ensure the accuracy and reliability of reported travel distances for compliance and reimbursement purposes.

What information must be reported on reviewed and acknowledged km?

The information that must be reported on reviewed and acknowledged km includes the starting location, ending location, and total kilometers traveled for each trip.

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