Form Ftb Pub. 1345a - 2002 Head Of Household Schedule (4803e)
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22002 Head of Household Schedule (4803e)
1. Look at the chart below to identify the relationship of the person you believe qualified you for the Head
of Household filing status. Enter the code number for that relationship in the code box to the right.
Relationship
Code
Son, Daughter, Stepson, or Stepdaughter
1
Grandchild
2
Foster Child
3
Father or Mother
4
Brother, Sister, Stepbrother, Stepsister,
Code
Grandfather, Grandmother, Stepfather, Stepmother,
5
Son-in-law, Daughter-in-law, Father-in-law, Mother-in-law,
Brother-in-law, or Sister-in-law
Uncle, Aunt, Nephew, or Niece
6
Other (please explain) _______________________________
7
(You cannot claim yourself, your spouse, or your tax preparer.)
2. Provide the social security number, name, and age of the qualifying person you indicated in question 1.
Social Security Number:
-
-
Name: ___________________________
Age in years as of 12/31/2002:
If less than one year old, age in months:
3. Were you entitled to claim the qualifying person as your dependent for 2002?
Yes.
No.
4. Did the qualifying person live with you the entire year in 2002?
Yes. Go to Question 6.
No. List the beginning and ending dates of each period the qualifying
person lived with you during 2002, or provide the total number of
days the qualifying person lived with you during 2002.
/
/
/
/
From
To
/
/
/
/
From
To
Total number of days
/
/
/
/
(More than 12 hours each day)
From
To
OR
/
/
/
/
From
To
FTB 4803e 2002
Page
1
FTB Pub. 1345A
2002 e-file Handbook Supplement for Authorized e-file Providers of California Individual Income Tax Returns
61
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