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PRINTED: 11/22/2023 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION
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in00421005, in00419889, and in00415995 are specific codes used for identifying particular forms or filings related to tax or compliance requirements in a regulatory framework.
Entities or individuals that meet certain criteria outlined by the governing authority, such as income thresholds or specific business activities, are required to file these forms.
To fill out these forms, one must gather the necessary financial and personal information, follow the instructions provided on the forms carefully, and ensure all required fields are completed accurately.
The purpose of these forms is to ensure compliance with tax regulations, accurately report financial information, and provide transparency to the governing authority.
Information such as income, deductions, tax credits, and any other relevant financial data must be reported on these forms.
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