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10/16/2020PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION
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The printed 1209 form approved is a specific tax form used for reporting certain types of income or financial information to the appropriate tax authorities.
Individuals or entities that meet specific income thresholds or engage in certain transactions as defined by tax regulations are required to file the printed 1209 form approved.
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