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PRINTED: 06/25/2019 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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What is printed 0821 - form?

The printed 0821 form is a tax form used for reporting certain types of income to the IRS.

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Individuals or businesses who receive income that falls under the reporting requirements of the 0821 form are required to file it.

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The purpose of the printed 0821 form is to report specific types of income to the IRS for tax purposes.

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The printed 0821 form requires the reporting of income information, such as amounts earned and taxes withheld.

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