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DocuSign Envelope ID: A10EC13DE176404DABD7B8AEDEFDD14EContract Review Sheet HE614624HE614624Contract for Services #:Amendment #:Contact: Kristina BallowDepartment: Health and Human ServicesPhone #:
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HE-6146-24 is a specific form used for reporting information related to certain regulatory or compliance requirements.
Entities or individuals that fall under the jurisdiction of the regulatory body overseeing the requirements of HE-6146-24 are required to file this form.
To fill out HE-6146-24, you need to provide the required information in the designated sections, ensuring accuracy and compliance with the instructions provided.
The purpose of HE-6146-24 is to collect necessary information for regulatory compliance and to ensure that requirements are being met by the filing entities.
Information that must be reported on HE-6146-24 typically includes identification details of the filer, the nature of the reportable activities, and any relevant compliance data.
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