Schedule A: Homeowners-Itemize
Name
*
First Name
Last Name
Email
*
example@example.com
MEDICAL AND DENTAL EXPENSES
Total Medical
Total Mileage x .165
1.
1.
1. Doctor/Dentist/Hospital/Drugs/Transportation/Lodging (.165 cents x mi.) (Must exceed 7 1/2 of AGI)
TAXES
Primary Residence
Secondary Residence
(- Less Rebate)
6. (1)
6. (2)
6. (2)
6. Real Estate Taxes
8.
Other Taxes (List)
SWT $
SUI/SDI $
INTEREST YOU PAID
10. $
10.
10. Home Mortgage Interest/Points Paid to Bank on Form 1098
10. Home Mortgage Interest/Points Paid to Bank on Form 1098
Name
Address
SS#
11.
11. Other Home Mortgage Interest not reported on Form 1098
%
# of years
12.
12. Points Not Reported to you on Form 1098 (Refinanced Points)
13.
13. Qualified Mortgage Insurance (PMI)
14.
14. Invest Interest
GIFTS TO CHARITY *MUST HAVE PROOF
16.
16. Cash or Check contribution (if $250 or more, list)
17.
17. Non - cash contribution (Over $500 attach form 8283)
MISCELLANEOUS DEDUCTIONS (NOTE MUST EXCEED 2% OF AGI)
21. Unreimbursed Employee Expense (Complete & Attach 2016 or 2106EZ
Browse Files
Cancel
of
22.
22.
22. Tax Preparation Fees
22. Union Dues
28.
28. Gambling/Lottery losses (Note to exceed gambling winnings)
Please verify that you are human
*
Submit
Should be Empty: