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Note: If you are completing Form 3604 for an Intermediate Care Facility for Individuals with an Intellectual Disability or Related Conditions, then you must also complete Form 3604-A, Ownership Transfer Affidavit Addendum for ICF/IID.
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Note: If you are completing Form 3604 for an Intermediate Care Facility for Individuals with an Intellectual Disability or Related Conditions, then you must also complete Form 3604-A, Ownership Transfer Affidavit Addendum for ICF/IID.