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Get CA CalPERS Continued Monthly Residence Form 2018-2024

Horoughly by facility staff. Ensure copies of current BLANK CMR forms are maintained by the facility. Complete a form for each month, on or after the last day of the month, after the services have been provided. (Example: Facility charges from June 1st-June 30th should not be submitted prior to July 1st). Submit with a copy of the facility s invoice reflecting room and board charges for the service period. Incomplete forms and photocopies of a prior month s completed CMR form.

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