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PRINTED: 03/11/2022 FORM APPROVED Indiana State Department of Health STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:CEDARHURST OF DYER (X4) ID PREFIX

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What is form PSR completed on?

Form PSR is completed on the Personal Statement of Affairs.

Who is required to file form PSR completed on?

The individual or entity required to file Form PSR is typically a debtor in a bankruptcy case.

How to fill out form PSR completed on?

Form PSR is filled out by providing detailed information about the debtor's assets, liabilities, income, expenses, and financial affairs.

What is the purpose of form PSR completed on?

The purpose of Form PSR is to provide the bankruptcy court with a comprehensive overview of the debtor's financial situation.

What information must be reported on form PSR completed on?

Information reported on Form PSR includes details about the debtor's assets, liabilities, income, expenses, and any financial transactions.

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