Form 540 2ez - California Resident Income Tax Return - 2005 Page 2
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Your name _____________________________ Your SSN or ITIN: _________________________
21
Total tax withheld (federal Form W-2, box 17 or CA Sch W-2, box 17
Overpaid
0 0
Tax/ Tax Due
. . . . .
and/or Form 1099-R, box 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21
,
“Attach a copy of your
. . . . .
0 0
22
Overpaid tax. If line 21 is more than line 20, subtract line 20 from line 21 . . . .
22
,
Form(s) W-2 or
complete CA Sch W-2”
23
Tax due. If line 21 is less than line 20, subtract line 21 from line 20.
0 0
See instructions, page 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
. . . . .
,
Use Tax
¼ ¼ ¼ ¼ ¼
0 0
. . . . .
24
Use tax. This is not a total line. See instructions, page 9 . . . . . . . . . . . . . . .
24
,
Contributions
Voluntary Contributions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Code
Amount
¼ ¼ ¼ ¼ ¼
00
California Seniors Special Fund. See instructions, page 10 . . . . . . . .
52
________________
¼ ¼ ¼ ¼ ¼
00
Alzheimer’s Disease/Related Disorders Fund . . . . . . . . . . . . . . . . . . .
53
________________
¼ ¼ ¼ ¼ ¼
00
California Fund for Senior Citizens . . . . . . . . . . . . . . . . . . . . . . . . . . .
54
________________
¼ ¼ ¼ ¼ ¼
00
Rare and Endangered Species Preservation Program . . . . . . . . . . . .
55
________________
¼ ¼ ¼ ¼ ¼
00
State Children’s Trust Fund for the Prevention of Child Abuse . . . . . .
56
________________
¼ ¼ ¼ ¼ ¼
00
California Breast Cancer Research Fund . . . . . . . . . . . . . . . . . . . . . .
57
________________
¼ ¼ ¼ ¼ ¼
00
California Firefighters’ Memorial Fund . . . . . . . . . . . . . . . . . . . . . . . . .
58
________________
¼ ¼ ¼ ¼ ¼
00
Emergency Food Assistance Program Fund . . . . . . . . . . . . . . . . . . . .
59
________________
¼ ¼ ¼ ¼ ¼
00
California Peace Officer Memorial Foundation Fund . . . . . . . . . . . . .
60
________________
¼ ¼ ¼ ¼ ¼
00
California Military Family Relief Fund . . . . . . . . . . . . . . . . . . . . . . . . .
63
________________
¼ ¼ ¼ ¼ ¼
00
California Prostate Cancer Research Fund . . . . . . . . . . . . . . . . . . . .
64
________________
¼ ¼ ¼ ¼ ¼
Veterans’ Quality of Life Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
65
________________
00
¼ ¼ ¼ ¼ ¼
00
California Sexual Violence Victim Services Fund . . . . . . . . . . . . . . . .
66
________________
¼ ¼ ¼ ¼ ¼
00
California Colorectal Cancer Prevention Fund . . . . . . . . . . . . . . . . . .
67
________________
¼ ¼ ¼ ¼ ¼
0 0
. . . . .
25 Add line 52 through line 67. These are your total contributions . . . . . . . . . . . . .
25
,
Refund or
26 REFUND or NO AMOUNT DUE. Subtract line 24 and line 25 from line 22. If line 22
Amount You
is less than line 24 and line 25, enter the difference on line 27.
Owe
See instructions, page 11. Mail to:
0 0
FRANCHISE TAX BOARD, PO BOX 942840, SACRAMENTO CA 94240-0002. . . . .
26
. . . . .
,
27 AMOUNT YOU OWE. Add line 23, line 24, and line 25.
See instructions, page 11. Mail to:
0 0
FRANCHISE TAX BOARD, PO BOX 942867, SACRAMENTO CA 94267-0001 . . . .
27
. . . . .
,
Pay online – Go to our Website at
Get Your Refund Faster with Direct Deposit
Do not attach a voided check or a deposit slip. See instructions, page 11.
¼ ¼ ¼ ¼ ¼
Fill in the boxes to have your refund directly deposited. Routing number . . .
Direct
Deposit
¼ ¼ ¼ ¼ ¼
¼ ¼ ¼ ¼ ¼
Account Type:
Checking
Savings
(Refund Only)
¼ ¼ ¼ ¼ ¼
Account number . . . . . . . . . . . . .
Under penalties of perjury, I declare that, to the best of my knowledge and belief, the information on this return is true, correct, and
complete.
3
Sign Here
It is unlawful to
Your signature
Spouse’s signature (if filing jointly, both must sign)
Daytime phone number (optional)
forge a spouse’s
)
(
signature.
X
X
Date
Joint return?
Paid Preparer’s SSN/PTIN
Paid preparer’s signature (declaration of preparer is based on all information of which preparer has any knowledge)
See instructions,
¼
page 12.
Firm’s name (or yours if self-employed)
Firm’s address
FEIN
¼
Side 2 Form 540 2EZ
2005
2EZ05203
C1
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