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SCHEDULE A
(Form 1040)

OMB No. 1545-0074

Itemized Deductions

Department of the Treasury
Internal Revenue Service (99)

▶ Information

about Schedule A and its separate instructions is at www.irs.gov/schedulea.
▶ Attach to Form 1040.

Name(s) shown on Form 1040

Medical
and
Dental
Expenses
Taxes You
Paid

Interest
You Paid
Note:
Your mortgage
interest
deduction may
be limited (see
instructions).

Caution: Do not include expenses reimbursed or paid by others.
1 Medical and dental expenses (see instructions) . . . . .
1
190875
2 Enter amount from Form 1040, line 38
2
3 Multiply line 2 by 10% (0.10). But if either you or your spouse was
born before January 2, 1952, multiply line 2 by 7.5% (0.075) instead 3
4 Subtract line 3 from line 1. If line 3 is more than line 1, enter -0- . .
5 State and local (check only one box):
a ✔ Income taxes, or
. . . . . . . . . . .
5
b
General sales taxes
6 Real estate taxes (see instructions) . . . . . . . . .
6
7 Personal property taxes . . . . . . . . . . . . .
7
8 Other taxes. List type and amount ▶
8
9 Add lines 5 through 8 . . . . . . . . . . . . . . . .
10 Home mortgage interest and points reported to you on Form 1098 10
11 Home mortgage interest not reported to you on Form 1098. If paid
to the person from whom you bought the home, see instructions
and show that person’s name, identifying no., and address ▶

0

19087.5

.

.

.

.

.

.

4

171787.5

}

11
12 Points not reported to you on Form 1098. See instructions for
special rules . . . . . . . . . . . . . . . . .
12
13 Mortgage insurance premiums (see instructions) . . . . .
13
14 Investment interest. Attach Form 4952 if required. (See instructions.) 14
15 Add lines 10 through 14 . . . . . . . . . . . . . . .
Gifts to
16 Gifts by cash or check. If you made any gift of $250 or more,
see instructions . . . . . . . . . . . . . . . .
16
Charity
17 Other than by cash or check. If any gift of $250 or more, see
If you made a
gift and got a
instructions. You must attach Form 8283 if over $500 . . .
17
benefit for it,
18 Carryover from prior year . . . . . . . . . . . .
18
see instructions.
19 Add lines 16 through 18 . . . . . . . . . . . . . . .

Casualty and
Theft Losses

2016

Attachment
Sequence No. 07
Your social security number

20 Casualty or theft loss(es). Attach Form 4684. (See instructions.) .

.

2500

.

.

.

.

.

.

9

14000

.

.

.

.

.

.

15

14000

12040

.

.

.

.

.

.

19

12040

.

.

.

.

.

.

20

13400

27

0

28

21400

29

42880

Job Expenses 21 Unreimbursed employee expenses—job travel, union dues,
and Certain
job education, etc. Attach Form 2106 or 2106-EZ if required.
Miscellaneous
21
(See instructions.) ▶
Deductions
22 Tax preparation fees . . . . . . . . . . . . .
22

3600

23 Other ex...


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