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PRINTED: 03/07/2022 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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0307 form approved is a tax form used to report certain types of income to the IRS.
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Individuals or entities who have received income that falls under the reporting requirements of 0307 form approved.
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