LIIC JELVIII CUI UUly puyin UrlVUILS VEIC JUILULU IVI LICITIUILIIV UITUITIUILI puy Un peruus u went into effect as planned. The form was completed and signed on April 11, 2018. FICA Yes Benefit Information Health Insurance Life Insurance Long-term Care FSA 401(k) Gymn Exclude: Federal Yes Yes Yes Yes Yes No Owner's name: Toni Prevosti Address: 850, Westminster Road, Bridgewater, VT, 00520. Phone: 802-555-3456 Number of employees: 8 Quarterly wages: $32,010.19 Federal income tax withheld: $942.00 401(k) contributions: $1,257.65 Insurance withheld: $4,080.00 Gym membership: $90.00 Amount Monthly Deposits Month 1 Month 2 Month 3 $ 2,109.22 $ 3,106.08 Required: Complete Form 941 for Prevosti Farms and Sugarhouse. Prevosti Farms and Sugarhouse was assigned EIN 22 -(NOTE): Instructions on format can be found on certain cells within the forms. Complete this question by entering your answers in the tabs below. LIIC JELVIII CUI UUly puyin UrlVUILS VEIC JUILULU IVI LICITIUILIIV UITUITIUILI puy Un peruus u went into effect as planned. The form was completed and signed on April 11, 2018. FICA Yes Benefit Information Health Insurance Life Insurance Long-term Care FSA 401(k) Gymn Exclude: Federal Yes Yes Yes Yes Yes No Owner's name: Toni Prevosti Address: 850, Westminster Road, Bridgewater, VT, 00520. Phone: 802-555-3456 Number of employees: 8 Quarterly wages: $32,010.19 Federal income tax withheld: $942.00 401(k) contributions: $1,257.65 Insurance withheld: $4,080.00 Gym membership: $90.00 Amount Monthly Deposits Month 1 Month 2 Month 3 $ 2,109.22 $ 3,106.08 Required: Complete Form 941 for Prevosti Farms and Sugarhouse. Prevosti Farms and Sugarhouse was assigned EIN 22 -(NOTE): Instructions on format can be found on certain cells within the forms. Complete this question by entering your answers in the tabs below