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PRINTED: 10/28/2019 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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The 1028 form approved is used to report information regarding payments made in the course of a trade or business.
Any person, including a corporation, partnership, individual, estate, and trust, that makes reportable transactions must file Form 1028.
Form 1028 is filled out by providing information about the payer, payee, payment amount, and the purpose of the payment.
The purpose of Form 1028 is to report certain payments made in the course of a trade or business to the IRS.
Information such as the payer's name, address, and taxpayer identification number, the payee's name, address, and taxpayer identification number, the payment amount, and the purpose of the payment must be reported on Form 1028.
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