Itemized Deduction Worksheet
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1Itemized Deduction Worksheet
TAX YEAR__________________
Medical Expenses. Must exceed 7.5% of income
Charitable Contributions. If over $500 in noncash
to be a benefit. Include cost for dependents-do not
include any expenses that were reimbursed by insurance
contributions, provide details of contributions. New rules require
Dentists
$
Hospitals
$
that the taxpayer train documentation for all cash contributions.
Cash
$
Doctors
$
Insurance
$
Noncash contributions (FMV).
$
Equipment
$
Prescriptions
$
Clothing or household items
must be in good used
Eyeglasses
$
Other
$
condition or better.
Medical Miles ___________________________
Did you transfer funds from an
YES
NO
$_______
IRA directly to a charity?
Taxes Paid. Do not include taxes paid for full or practical
business or rental-use property, including business
Charitable mileage
use of the home
Casualty and Theft Losses.
If you suffered any sudden, unexpected damage or loss of property, or
On W-2
State Withholding
a theft, provide details to your tax preparer
YES
NO
Miscellaneous Itemized Deductions. The following must exceed 2%
State estimated taxes-paid last year
$
of income to be a benefit. For use of home, or auto mileage, or other
Real estate tax-residence
$
job-related expenses, provide information on a separate sheet.
Were any expenses reimbursed by your employer?
YES
NO
Real estate tax-other
$
Personal property taxes
$
Dues
$
Supplies
$
Property tax refund-last year
$
Investment
$
Tax prep fees
$
Foreign tax paid
$
expenses
Job education
$
Tools
$
Other
$
Job seeking
$
Uniforms
$
Other
$
Legal fees
$
Union dues
$
Balance paid in last year from prior years
$
Licenses
$
Other
$
return (do not include interest or penalties)
Safety
$
Other
$
equipment
Did you keep receipts for sales tax paid last year?
Subscriptions
$
Other
$
YES
NO
Other Miscellaneous Deductions. The following deductions are not
Did you purchase a car, plane, boat, or home last year?
subject to a 2% of income limit.
YES
NO
Gambling
$
Federal estate tax
$
Sales tax paid $_____ Purchase paid $ _______ Date
losses
on IRD
__/___/____
Impairment-
$
Loss from 2(a), K-
$
related exp.
1, Form 1065 B
Interest Paid. Do not include interest paid for full or partial
Notes:
business
1.Gambling losses are deductible only up to the amount of the
or rental-use property, including business use of the home.
gambling winnings reported. A log must be kept to verify losses. 2.
Provide
Work clothing is not deductible if adaptable for every day wear.
Forms 1098 or lender information and ID numbers.
Exception for safety equipment, such as steel-toe boots. 3. Legal
expenses are deductible only if related to producing or collecting
Main home
$
Equity loan
$
taxable income. 4. Expenses to enable individuals, who are physically
Second
$
Equity loan
$
or mentally impaired, to work are generally deductible.
home
Adjustment Worksheet
Points
$
Investment
$
interest
Educator expenses. Classroom expenses of teachers,
Did you pay mortgage insurance premium when you
counselors, and principals. Maximum $250 each ($500 joint).
purchased your home? Amount $_______ Date ___/___/____
Health savings account deduction (HSA)
Self-employed SEP, AIMPLE, and qualified plans. Some
contributions for last year may be made this year
____________________
Other Deductions or Questions.
Self-employed health insurance deduction.. Sole proprietors,
_____________________________________________
partners, and 2% S corporation shareholders if not eligible for
_____________________________________________
employer coverage.
Penalty on early withdrawal of savings
_____________________________________________
IRA deduction. For traditional IRAs. Roth IRAs are not
deductible. Some contributions for last year may be made this
year
Student loan interest deduction. Paid for taxpayers and
TODAY’S DATE_________________
dependents. Income limits apply
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