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7 —E_ <br />Excess Local <br />LINE /ITEM JUSTIFICATION <br />Total Cost <br />Federal <br />Non - Federal <br />Support <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 />Agency Fringe Benefits <br />FICA _0765, % <br />Unemployment % <br />Retirement % <br />Health Insurance % <br />Llfe Insurance % <br />Workmen's Compensation % <br />Total Percentage of <br />Fringe Benefits .0765 % <br />FICA % .0765 X Total Applicable <br />Wages 4,992 = 382 <br />Unemployment % X Tutal <br />Applicable Wages = <br />Retirement % X Total <br />Applicable Wages = <br />Health Insurance % X Total <br />Applicable Wages = <br />Life Insurance % X Total <br />Applicable Wages X <br />Workmen's Compensation % X <br />Total Applicable Wages = <br />Clerical Data Entry Aide <br />TOTAL FRINGE BENEFITS <br />382 <br />382 <br />7 —E_ <br />