Form 14581-A - Fringe Benefits Compliance Self-Assessment For Public Employers Page 4

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Page 4
i. Moving expenses paid for any workers
Yes
No
Follow Up
Note: Exempt (up to limits) if expenses would be deductible if the employee had paid them.
These rules are further illustrated in Publication 521, Moving Expenses.
Comments
j. Gift Certificates given to any workers
Yes
No
Follow Up
Note: Gift certificates that are cash equivalent are not excludable from income as de minimis fringe benefits.
Comments
Notes/Follow-up
You have completed the Fringe Benefits Compliance Self-Assessment.
14581-A
Catalog Number 69844Y
Form
(6-2017)

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