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Itemized Personal Information

 

 

Name:    Tax Year:

                                

            Medical and Dental             Charity and Donations
Health Insurance................. Donations - Money.............
Long Term Premiums.......... Donations - Material...........
Doctors.............................. Charity Mileage..................
Prescriptions....................... How To Determine Value IRS    Goodwill Guide    Salv Army Guide
Dentists..............................

            Interest Paid

Optical...............................

Home Mortgage................

Medical Mileage.................

Loan Points.......................

            Other Medical and Dental Qualified Mtg Insurance.....
Investment Interest.............
                                                         Taxes Paid                                                            
State Income Taxes............ General Sales Taxes...........
Real Estate Taxes............... Personal Taxes...................

                 (car registrations, etc)

            Other Taxes Paid
Prior Year Tax Prep Fee....
Gambling Losses................

   (up to W-2G Income Total only)

 

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