(Do not include expenses paid by insurance/HSA/MSA. Include doctors, dentists, nurses, prescription medicine, lab fees, hearing aids, eyeglasses, contact lenses, hospitals, medical transportation, and lodging.)
GIFTS TO CHARITY
If your non-monetary contributions total over $500, please describe the contributed items. Indicate the date, charity name, and address of the contributions; the date and cost of the original purchases; the value of contributions; and how you determined those values. For all contributions, you must keep canceled checks or written receipts. For all contributions over $250 you must keep written acknowledgement from the charity and have in possession before filing. For non-monetary contributions over $5,000, you must keep a written appraisal.