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PRINTED: 09/16/2019 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION
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Printed 0916 department is a form used for reporting income tax withheld on compensation and for providing information on the compensation paid by the employer during the tax year.
Employers are required to file printed 0916 department if they have withheld income tax from their employees' compensation.
Printed 0916 department can be filled out by entering the employer's information, the employee's information, and the details of the compensation and income tax withheld.
The purpose of printed 0916 department is to report income tax withheld on compensation and to provide information on the compensation paid to employees during the tax year.
Information such as employer's details, employee's details, compensation paid, and income tax withheld must be reported on printed 0916 department.
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