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LINE /ITEM JUSTIFICATION <br />B. Fringe Benefits <br />Please complete the attached work- <br />sheets for each person who is <br />charged to your grant and who is <br />eligible for fringe benefits. If <br />a person is part -time and not <br />eligible, please list the position <br />and indicate they are not eligible. <br />Please list below your agency <br />fringe benefits rates and then <br />complete the worksheets. <br />Asencv Fringe Benefits <br />FICA 7.65 % <br />Unemployment <br />Retirement <br />Health Insurance <br />Life Insurance <br />Workmen's Compensation <br />Total Percentage of <br />Fringe Benefits <br />FICA % 7.65 X Total Applicable <br />Wages 25,920 - <br />Unemployment % X Tutal <br />Applicable Wages = <br />Retirement % X Total <br />Applicable Wages = <br />Health Insurance % X Total <br />Applicable Wages = <br />+ Dental <br />Life Insurance % X Total <br />Applicable Wages X <br />Workmen's.Compensation % X <br />Total Applicable Wages <br />RSVP Director <br />TOTAL FRINGE BENEFITS <br />Excess Locai <br />Total Cost I Federal I Non - Federal I Support <br />$5,063 1$1,704 1 $1,659 $1,700 <br />