Form 4803e - Head Of Household Schedule - 2005 printable pdf download

Form 4803e - Head Of Household Schedule - 2005

DO NOT MAIL THIS FORM TO FTB

2005 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

Grandchild, brother, sister, stepbrother, stepsister, half-brother,

half-sister, nephew, or niece

Eligible foster child

Father or mother

Grandfather, grandmother, stepfather, stepmother; son-in-law,

Code

daughter-in-law, father-in-law, mother-in-law, brother-in-law,

sister-in-law, uncle, or aunt

Other (please explain) _______________________________

(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 12/31/2005:

If less than one year old, age in months:

3. Was your qualifying person’s gross income less than $3,200 in 2005?

Yes

4. Did you provide more than half the support for your qualifying person in 2005?

Yes

5. Was your qualifying person a full-time student at a recognized educational institution for at least five

months during 2005?

Yes

Did the qualifying person live with you the entire year in 2005?

Yes. Go to Question 8.

No. List the beginning and ending dates of each period the qualifying person

lived with you during 2005, or provide the total number of days the qualifying

person lived with you during 2005 and answer question 7.

From

Total number of days

(More than 12 hours each day)

From

Form 4803e - Head Of Household Schedule - 2005