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ATTACHMENT II B NOTICE OF INTENT TO DISCONTINUE YOUR PARTICIPATION IN THE LONG TERM HOME HEALTH CARE PROGRAM (THICK) NYC ONLY NOTICE DATE: EFFECTIVE DATE: CASE NUMBER NAME AND ADDRESS OF AGENCY/CENTER
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Attachment II B is a form used to report certain financial information to the relevant authorities.
Any entity or individual that meets the criteria set by the authorities for filing Attachment II B.
Attachment II B must be filled out accurately and completely according to the instructions provided by the authorities.
The purpose of Attachment II B is to provide the authorities with specific financial information for regulatory or compliance purposes.
Information such as income, expenses, assets, liabilities, and other financial data as required by the authorities.
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