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Online Forms and Procedures, docHub Forms, Frequently Used Forms, Leave Related Forms, Evaluation Forms, Search Forms, Procedures
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CERT-126 - CT.gov
Attach a signed and dated copy of the Facility Approval Letter from DRS identifying the low and moderate income housing facility named in the certificate and
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Medicare
If yes, enter the certification dates below. Line 126--If this is a Medicare certified kidney transplant center, enter the certification date in column 1
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