SCHEDULE A . . cryie 
[Farm 1040) Itemized Deductions ?55113 1 
Sepanmem cf the 1h ahcut Schedule A and its separate instructions is at m-I:h:em
Internal Fleyenue Ear-ace Isa Ir Attach tc Farm 11.21413. Sequgn?e my 
Namelsl an 15515 ?i'cur sccial security number
Bauticn: Dc include expenses reimbursed cr paid by cthers.

1 Medical and dental expenses {see instructicns311d 1 3 Enter amcunt Farm 1545, line 35 I I I 
Dental 3 Multiply line 2 by MW
5

4 Subtract line 3 line1. If line 3 is mcre than line 1,enter -ElTaxes 5 State and lccal [check cnly cne bcxi:
Paid a Inccme taxesGeneral sales taxes ?ii ?Ft

5 Fieal estate taxes [see instructicnsF'erscnal prcperty taxes . . . . . . . . . . . i"

5 DthertaI-Ies List type and amcunt Ir."

a Capped at

Addlines5thrcugh5 . . . . . . . . . . . . a $10,000

Interest 15 Hcme interest and pcints repcrted tc ycu cn Farm 1555 1D

 

Ygu Paid 11 Hcme interest repcrted tc ycu cn Farm 1555. It paid
tc the perscn tram ycu caught the heme. see instructicns

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

?etc: and shct'. Ina: cerscn's name, identifying ha, and address II-
?fcur 
interest .. ..
deducticn may 11
be ??1535 Pcints repertecl tc ycu crI Farm 1595. See instructicns 
instm?i?ns}' special rules . . . . . . . . . . . . . . . . . 12
insurance premiums {see instructicns} - - - 13
14 inyestment interest. Attach c1552 if required. {See instructicnsGifts to 15 Gifts by cash cr check. It ycu made any gift 515255 cr mcre
Charity see instructicns . . . . 15
WU made a 1? Either than by cash cr check. If any gift 5152512} cr mcre see
gin and pat a instructicns- ?I'cu must attach Farm 5253 if ever $51215 - - - . 
hen5?mr it; 15 pricr year . . . . . . . . . . . . 15 
19 Add lines 15thrcugh 1sIs_
BHEUHIW and Only for federal disaster areas If
25 lCasualty cr theft Icsstest Attach 4:155:11. [See instructicnses?Enarmm?wsa?m?ae lasl Ether 25 Dtheretrcm list in instructicns. List type and amcunt Ir
Miscellanenus
Deduc?cns . .. . . .1 . . .. .23
Tctal 251 Is 15-15, line 35. cyer $1 55.551]?
Itemized FL Nc. ?I?cur deducticn is net limited. Add the amcunts in the far right cclumn
Deducticns icr lines 4 thrcugh 25. Alec, enter this amcunt cn 1541i], line All . . 25
?mlml i? 'mluctim'? ED El ?5 E5 Bum"
'53 30 If ycu elect tc itemize deducticns eyen thcugh they are less than ycur standard
deducticn,checlthere . . . . . . . . . . . . .Ir r!

 

 

 

PaperwcrI-r. Fleducticn Act Hctice. see Farm 1545 instructicns+ Est. Hc- 11'1-15c schedule A [Fcn11 15-10} 20113