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PRINTED: 12/14/2020
FORM APPROVEDDivision of Health Service Regulation
STATEMENT OF DEFICIENCIES
AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA
IDENTIFICATION NUMBER:CLARA\'S COTTAGE FAMILY CARE
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What is printed 1214 form approved?
The printed 1214 form approved is a tax form used for reporting certain types of income.
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Individuals or entities who received income that falls under the reporting requirements of the form are required to file it.
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The form must be completed with accurate information regarding the income received and any applicable deductions.
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