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PRINTED: 01/06/2022
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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What is what kind of form?
{'form': 'Employment Tax Form'}
Who is required to file what kind of form?
{'required': 'Employers who pay wages to employees are required to file the Employment Tax Form'}
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{'filling out': 'Employers need to provide information about wages, tips, and other compensation paid to employees'}
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{'purpose': 'The Employment Tax Form is used to report employment taxes, such as Social Security and Medicare taxes, withheld from employees'}
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{'information reported': 'Wages, tips, and other compensation paid to employees, as well as taxes withheld, must be reported on the Employment Tax Form'}
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