Contra Costa California Form 4564 2017-2025

Contra Costa California Form 4564: What You Should Know

You may request by e-mailing [Form ID] [Name of Taxpayer and Company, Form ID] The following are excerpts from the document in the attached document (copies of the same document may also be obtained from the Contra Costa Tax Authority at: 859 L St., Suite 1401, Ste. 300, Richmond, CA 94801; or from the San Francisco office at: 888 F St., 7th Floor, San Francisco, CA 94105). CONTRA COSTA COUNTY CONTINUING PRACTICE PHYSICIANS' BENEFITS. FOR EXEMPT MEDICAL STAFF The  Income Tax Benefit Program in [Form 4400 — Income Tax Benefit Schedule] To provide a tax benefit to physicians who participate in the following ongoing practice group program: If the [Name of Provider] is a physician, or the  Income Tax Benefit is being provided in lieu of payment by  Medicare or any other government program, in the amount the  provider is required to file with your [Tax] [Name of Provider] , as described  below, (or any amount your [Taxpayer] is able to pay in lieu)  and meets the requirements set forth in [Form 4400 — Income Tax Benefit Schedule], an  [Amount of Income Tax Benefit] was reported on the preceding January  Income Tax Return due to the Medicare Payment System, the  provider's filing status (e.g., active, retired, or on active medical  participation), and the physician's filing status with the  Medicare Payment System. For a more complete description, please  see Appendix A; and see [Form 4400 — Income Tax Benefit Schedule (X)] (below). In order to qualify, [Name of Provider] will be required to participate  on the calendar and monthly basis at the following locations: 1.

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