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PRINTED: 01/20/2026 DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICESOMB NO. 09380391STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTIONS(X1) PROVIDER/SUPPLIER/CLIA
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Printed 01202026 is a form used by the Department of Revenue for tax reporting purposes.
Individuals or businesses that have specific tax obligations as determined by the Department of Revenue are required to file the printed 01202026.
To fill out printed 01202026, obtain the form from the Department of Revenue's website, ensure accurate reporting of all required information, and follow the submission instructions provided.
The purpose of printed 01202026 is to collect tax information from taxpayers to ensure compliance with state tax laws and regulations.
The information that must be reported includes taxpayer identification details, income, deductions, and any other relevant financial data as specified by the Department of Revenue.
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