- 11 -
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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Last modified: November 10, 2007