California Form 3506 - Child And Dependent Care Expenses Credit - 2006
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CALIFORNIA FORM
YEAR
3506
2006
Child and Dependent Care Expenses Credit
Attach to your California Form 540, 540A, or Long Form 540NR.
Name(s) as shown on return
SSN or ITIN
-
-
Part I
Unearned Income and Other Funds Received in 2006. See instructions.
SOURCE OF INCOME/FUNDS
AMOUNT
SOURCE OF INCOME/FUNDS
AMOUNT
Part II Persons or Organizations Who Provided the Care in California – You must complete this part. See instructions.
Enter the following information for each person or organization that provided care in California. (Only care provided in California qualifies for the credit).
If you need more space, attach a separate sheet.
Provider
Provider
a. Care provider’s name
b. Care provider’s address
(number, street, apt. no., city, state, and
ZIP Code)
c. Care provider’s telephone number
(
)
(
)
d. Is provider a person or organization?
Person
Organization
Person
Organization
e. Identification number (SSN or FEIN)
f. Address where care was provided
(number, street, apt. no., city, state, and
ZIP Code)
g. Amount paid for care provided
Did you receive dependent care benefits?
No Complete Part III below.
Yes Complete Part IV before Part III.
Part III Credit for Child and Dependent Care Expenses
2 Information about your qualifying person(s). See instructions.
(a)
(b)
(c)
(d)
(e)
Qualifying person’s name
Qualifying person’s
Qualifying person’s
Percentage of physical
Qualified expenses you
social security number
date of birth (DOB)
custody
incurred and paid in 2006 for
(See instructions)
or if disabled
(See instructions)
the qualifying person’s
First
Last
care in California
DOB:_____________
Disabled Yes
DOB:_____________
Disabled Yes
DOB:_____________
Disabled Yes
3 Add the amounts in column (e) of line 2. Do not enter more than $3,000 for one qualifying person or $6,000 for two
or more qualifying persons. If you completed Part IV, enter the amount from line 35 . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
4 Enter YOUR earned income. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
Nonresidents: Enter only your earned income from California sources. If you do not have earned income from
California sources, stop, you do not qualify for the credit. Military members, see instructions.
Part-year residents: Enter the total of (1) your earned income from California sources received while you were a
nonresident and (2) all earned income received while you were a resident. Military members, see instructions.
5
I
f married filing a joint return, enter YOUR SPOUSE’S earned income. (If your spouse was a student or was
disabled, see the instructions.) If not filing a joint return, enter the amount from line 4 . . . . . . . . . . . . . . . . . . . . . . . . .
5
Nonresidents: Enter only your spouse’s earned income from California sources. If your spouse does not have earned income
from California sources, stop, you do not qualify for the credit. Military members, see instructions.
Part-year residents: Enter the total of (1) your spouse’s earned income from California sources received while he or she was a
nonresident and (2) all earned income your spouse received while he or she was a resident. Military members, see instructions.
6 Enter the smallest of line 3, line 4, or line 5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
X. ___ ___
7 Enter the decimal amount shown in the chart on page 3 of the instructions for line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
8 Multiply line 6 by the decimal amount on line 7. Enter the amount here and on Form 540A, line 30;
Form 540, line 42; or Long Form 540NR, line 49 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
X. ___ ___
9 Enter the decimal amount listed in the chart on page 3 of the instructions for line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
0 Multiply the amount on line 8 by the decimal amount on line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0
Credit for prior year expenses paid in 2006. See instructions for line 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Add line 10 and line 11. Enter the amount here and on Form 540A, line 31; Form 540, line 43; or Long Form 540NR, line 50
2
7251063
FTB 3506 2006 (REV.2 03-07) Side
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