Printable .PDF Version
Itemized Deductions Worksheet
Printable .PDF Version
Posted by Taxprosites.com on 10/7/04 Prepared by Back to Basics Seminars
You can itemize if your expenses exceed the standard deduction:
Single - $4750, Married filing joint - $9500, Head of Household - $7000
MEDICAL & DENTAL (Expenses must exceed 7.5% of adjusted gross income)
Prescription medicines, drugs & insulin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Doctors, dentists, nurses, hospitals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Insurance premiums . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Transportation for medical care – miles__________X .12 . . . . . . . . . . . . . . . . . . . . . . . _______________
Lodging for medical care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Other: (hearing aids, dentures, eyeglasses, air conditioners, & air purifiers purchased for
Medical reasons) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Estimated state & local income taxes paid in 2003 for 2003 . . . . . . . . . . . . . . . . . . . . _______________
Balance of state & local income tax paid in 2004 for 2003. . . . . . . . . . . . . . . . . . . . . . _______________
School, county, & local real estate tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Personal property tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Other taxes: Description _________________________________________________ _______________
Home mortgages – bank . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Home mortgage – individual (SS #______-____-________) . . . . . . . . . . . . . . . . . . . . . _______________
Name ________________________________ Address____________________________________________
Points not reported to you on Form 1098 & paid in 2002 . . . . . . . . . . . . . . . . . . . . . . . _______________
Home equity loan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Interest paid to maintain investments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Cash or check contributions (church, United Fund, etc.) . . . . . . . . . . . . . . . . . . . . . . . . _______________
(For a single gift of $250 or more you must have signed receipt)
Other than cash (used clothing, Red Cross, Little League, food donations to tax exempt
organizations: fire co. boy scouts, etc.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
(If “Other than Cash” exceeds $500, list items and dollar value).
Travel for charitable work (boy scouts, Little League, church, etc.)
# of miles for above __________X .14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
(OVER PLEASE)
Losses NOT covered by insurance coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
# miles from old home to old job __________, # miles from old home to new job __________
(If the difference is more than 50 mi. you can deduct moving expenses)
Actual moving expenses (transporting, etc.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
MISCELLANEOUS DEDUCTIONS (Subject to a 2% limitation)
Union Dues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Professional Dues & Licenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Professional Books or Subscriptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Continuing Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Books & Supplies to keep tax records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Tax return preparation fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Mileage to tax preparer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Safe Deposit Box . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Work Uniforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Launder Uniforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Work Tools (scissors, flashlights, etc.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Safety Equipment (shoes, gloves, glasses, etc.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Miles traveled in your auto for your company not reimbursed . . . . . . . . . . . . . . . . . . . . _______________
Miles traveled from your Job #1 to Job #2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Miles traveled to temporary jobs over 35 miles one way . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Lodging expenses NOT reimbursed for temporary job . . . . . . . . . . . . . . . . . . . . . . . . . . . _______________
Meals NOT reimbursed for temporary job. Actual cost $ __________ No. of days __________
SALESMAN – OTHER EXPENSES
WHAT AMOUNT WHAT AMOUNT
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