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Amended SPRINTED: 09/04/2020 FORM APPROVEDDivision of Health Service Regulation STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:GRAYSON CREEK OF WELCOME

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What is amended sod?

Amended sod is a form submitted to make corrections or changes to a previously filed Statement of Distribution.

Who is required to file amended sod?

Any individual or entity who needs to correct information on a previously filed Statement of Distribution is required to file amended sod.

How to fill out amended sod?

To fill out amended sod, you need to provide the corrected information in the designated sections of the form and submit it according to the instructions provided.

What is the purpose of amended sod?

The purpose of amended sod is to ensure accuracy and transparency in reporting distributions of assets or funds.

What information must be reported on amended sod?

The information reported on amended sod should include details of the corrections or changes made to the previously filed Statement of Distribution.

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