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DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICESPOSTCERTIFICATION REVISIT REPORT PROVIDER / SUPPLIER / CIA / IDENTIFICATION NUMBER345406Y1MULTIPLE CONSTRUCTION A. Building

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What is 21c2i-iv?

21c2i-iv is a tax form used to report certain income.

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You must report details such as the amount of income received, the source of the income, and any relevant tax deductions on 21c2i-iv.

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