Name of taxpayer
Social Insurance Number
Printed
2011/02/12
Medical Expenses
T1-2010
Attach receipts (see line 330 in the guide). If you need more space, attach a separate sheet of paper.
Period covered by claim: From
Date of payment
Year Month Day
01/01/2010
Name of patient
to
31/12/2010
Payment made to:
Description
of medical expenses
Amount paid
Total medical expenses
Care for an attendant paid for
Amount of medical expenses to carry over to line 330 of Schedule 1
Less: 3% of line 236 (max $ 2,024 )
Subtotal
Amount of medical expenses to carry over to line 331 of Schedule 1
Total allowable portion of medical expenses
Note:
For amounts incurred solely for esthetical purposes, only enter the amounts incurred before March 4, 2010, because after
this date, these expenses will no longer be eligible for the credits for medical expenses.
G