Using the information from P5-10A for Leda Inc., complete Form W-3 that must accompany the company's Forms W-2. Leda Inc. is a 941-SS payer and is a private, for-profit company. No third-party sick pay applied for 2016.

Data from P5-10A

Leda Inc. is located at 433 Augusta Road, Caribou, Maine, 04736, phone number 201-555-1212. The Federal EIN is 54-3910394, and a Maine Revenue Services number of 3884019. Owner, Amanda Leda has asked you to prepare Form W-2 for each of the following employees of Leda, Inc. as of December 31, 2016.

Sarah C. Niehaus  122 Main Street, #3  Caribou, ME 04736  SSN 477-30-2234 Dependent Care Benefit: $1,800.00	Total 2016 wages: $34,768.53  401(k) contribution: $1,043.06  Section 125 contribution: $1,500.00  Federal income tax withheld: $4,833.82  Social Security Tax withheld: $2,062.65  Medicare tax withheld: $482.39  State Income tax withheld $2,561.92
Maxwell S. Law  1503 22nd Street  New Sweden, ME 04762  SSN: 493-55-2049	Total 2016 wages: $36,729.37  401(k) contribution: $1,469.18  Section 125 contribution: $1,675.00  Federal income tax withheld: $4,407.52  Social Security Tax withheld: $2,173.37  Medicare tax withheld: $508.29  State Income tax withheld $2,670.02
Siobhan E. Manning  1394 West Highway 59  Woodland, ME 04694  SSN: 390-39-1002  Tuition in excess of $5,250: $1,575.00 (include in box 1)	Total 2016 wages: $30,034.87  401(k) contribution: $712.75  Section 125 contribution: $1,000.00  Federal income tax withheld: $4,833.82  Social Security Tax withheld: $1,800.16  Medicare tax withheld: $421.01  State Income tax withheld $2,130.38
Donald A. Hendrix  1387 Rimbaud Avenue  Caribou, ME 04736  SSN: 288-30-5940	Total 2016 wages: $22,578.89  401(k) contribution: $1,354.73  Section 125 contribution: $2,250.00  Federal income tax withheld: $2,709.47  Social Security Tax withheld: $1,260.39  Medicare tax withheld: $294.77  State Income tax withheld $1,508.45
Alison K. Sutter  3664 Fairfield Street  Washburn, ME 04786  SSN: 490-55-0293	Total 2016 wages: $45,908.34  401(k) contribution: $2,754.50  Section 125 contribution: $1,750.00  Federal income tax withheld: $5,509.00  Social Security Tax withheld: $2,737.82  Medicare tax withheld: $640.30  State Income tax withheld $3,291.61