MEDICAL

FOR YOU, YOUR SPOUSE, ANY DEPENDENT YOU DECLARE

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Diagnose, cure, treat, improve, or prevent an illness or disease. Out of pocket expenses, must be over 7.5% of your adjusted gross income. Credit was extended. NJ  Residents! - your number is only   2% - so fill this page out & send in for a higher refund.

FA Deduction Form

YOUR INFORMATION

PREMIUMS

PROFESSIONAL

VISION

FACILITIES

LABS

SCANS

MEDICATIONS

EQUIPMENT

OTHER

CAPITAL IMPVTS

CLASSES

CONCEPTION

TRAVEL

REIMBURSEMENTS

DEDUCTIONS NOT ALLOWED

Health club fees. Vitamins. Cosmetic surgery. Teeth whitening. Maternity clothes. Funeral expenses. Vet fees. Herbal & Diet food - unless for a specific disease & you have a script. Lost gym club memberships.