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NAME(S) TAXPAYER ID

NAME(S) TAXPAYER ID TOTAL ITEMIZED DEDUCTIONS Multiply Line 2 by 7.5% (0.075) e. Add Line 8a through Line 8d Add Line 8e and Line 9 Medical and dental expenses MEDICAL AND DENTAL EXPENSES Enter amount from Federal Form.001040, Line 11 Subtract Line 3 from Line 1. If Line 3 is more than Line 1, enter 0.

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