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STATE OF CALIFORNIAHEALTH AND HUMAN SERVICES AGENCYCALIFORNIA DEPARTMENT OF SOCIAL SERVICES C ENCY/PENALTY REV EW Date: Facility Name: Facility Number: Invoice Number:DEAR LICENSEE: Per your request
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How to fill out invoice errors

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Review the invoice for accuracy
02
Correct any misspelled words or incorrect information
03
Verify all amounts match the agreed upon terms
04
Double check all calculations on the invoice
05
Ensure that the invoice is formatted correctly and legible before submitting

Who needs invoice errors?

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Anyone who prepares or receives invoices may encounter invoice errors
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Invoice errors refer to mistakes or inaccuracies on an invoice, such as incorrect amounts, wrong dates, or missing information.
Businesses and individuals who issue invoices are required to file invoice errors to correct any inaccuracies.
To fill out invoice errors, identify the errors on the original invoice, provide the correct information, and document the changes clearly.
The purpose of invoice errors is to ensure accurate financial records and facilitate correct billing between parties.
Invoice errors must report the original invoice number, the nature of the error, corrected amounts, and any additional relevant details.
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