Itemized Deductions First & Last Name Tax Year Date Submitted MedicalDrugs & Medicines Medical Insurance Premiums Doctors, Dentists & Hospitals Lab Fees, Eyeglasses, Hearing Aids Parking Medical Miles Insurance Reimbursements TaxesReal Estate Residence Real Estate/ Other Sales Tax State Income Tax Paid/ What state? Interest PaidHome Mortgage Mortgage Insurance Premiums Points Home Improvement Loan Investment Margin Interes Credit Card Interest NOT Deductible ContributionsAll Cash Contributions Other Than Cash what was donated What you paid for items (approx) Where you donated to (all locations) Date Donated Charitable Miles Casualty LossesAuto Accident Date Theft Date Tornado or Freeze (specify) Date Fire Date Other Date Unreimbursed Employee ExpensesProfessional/ Union Dues Safe Deposit Box Teachers Expenses Education Expense Tax Prep Fees Other (please specify) Gambling Losses (Not more than gambling income) Additional NotesPrintCAPTCHA
