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PRINTED: 10/05/2021 FORM APPROVEDDivision of Health Service Regulation STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:(X2) MULTIPLE CONSTRUCTION A.
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Mable's home is her primary residence where she resides.
Mable is required to file her home on her tax forms.
Mable can fill out her home information on the appropriate tax forms provided by the government.
The purpose of reporting Mable's home is to provide accurate information about her primary residence for tax and legal purposes.
Mable must report details such as address, ownership status, and usage of her home.
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