Darwin J. Albers & Peggy L. Albers - Page 11




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               portion or all of this plan year.  I [Mr. Albers] reviewed the         
               expenses listed, and these expenses have or will be reimbursed by      
               the employer pursuant to the plan.                                     
                      *       *       *       *       *       *       *               
               Section 3 Medical Expenses                                             
                      *       *       *       *       *       *       *               
             Year    Name of Care    Type of     Amount paid not                      
           Incurred    Provider      Service   covered by Insurance Date Paid         
                      *       *       *       *       *       *       *               
             2001      Dillon         Dental        507.00        08/03/01            
             2001      Dillon         Dental        525.00        04/11/01            
             2001      Dillon         Dental        173.00        01/15/01            
             2001      Dillon         Dental        765.00        09/18/01            
             2001      Horner      Orthodontist    1550.00        08/30/01            
             2001       Bliss         Dental        188.00        08/09/01            
             2001       Bliss         Dental        144.00        02/08/01            
             2001       Bliss         Dental        242.00        08/29/01            
             2001      Siestra       Eye Dr.        229.50        08/08/01            
             2001      Siestra       Eye Dr.        238.50        12/06/01            
             2001    Valentine-HBC  Physical        22.00         05/15/01            
             2001        CLM        Strep Test      22.58         06/08/01            
             2001   S.V. Physicians   Strep         24.00[12]     05/24/01            
                                    Screening                                         
               On April 15, 2002, petitioners filed Form 1040, U.S. Indi-             
          vidual Income Tax Return, for their taxable year 2001.  Petition-           
          ers’ 2001 Schedule F pertained to Mr. Albers’s farming business.            


               12The record does not establish that the $24 request for               
          reimbursement reflected in Ms. Albers’s employee benefit expense            
          form was paid in 2001 (or at any other time).  The parties agree            
          that the $8,216 deduction for “Employee benefit programs” claimed           
          in petitioners’ 2001 Schedule F included $4,630 claimed for                 
          services by medical and dental providers (claimed $4,630 of                 
          medical and dental expenses).                                               





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