Print and Reset Form
Reset Form
Your name: ____________________________ Your SSN or ItIN: _________________________
22
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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
,
0 0
23
overpaid tax. If line 22 is more than line 21, subtract line 21 from line 22. . . . . 23
,
.
24
tax due. If line 22 is less than line 21, subtract line 22 from line 21.
0 0
See instructions, page 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
.
,
Use Tax
0 0
25
Use tax. This is not a total line. See instructions, page 8 . . . . . . . . . . . . . . . . .
25
.
,
Contributions
Voluntary Contributions
Code
Amount
California Seniors Special Fund. See instructions, page 11 . . . . . . . . . . . . . . . . . 50
__________________
00
Alzheimer’s Disease/Related Disorders Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
__________________
00
California Fund for Senior Citizens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
__________________
00
Rare and Endangered Species Preservation Program . . . . . . . . . . . . . . . . . . . . . 53
__________________
00
State Children’s Trust Fund for the Prevention of Child Abuse . . . . . . . . . . . . . . . 54
__________________
00
California Breast Cancer Research Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
__________________
00
California Firefighters’ Memorial Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
__________________
00
Emergency Food Assistance Program Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
__________________
00
California Peace Officer Memorial Foundation Fund . . . . . . . . . . . . . . . . . . . . . . 58
__________________
00
California Military Family Relief Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
__________________
00
Veterans’ Quality of Life Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
__________________
00
California Sexual Violence Victim Services Fund . . . . . . . . . . . . . . . . . . . . . . . . . 61
__________________
00
00
California Colorectal Cancer Prevention Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
__________________
00
California Sea Otter Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
__________________
0 0
26 Add line 50 through line 63. these are your total contributions . . . . . . . . . . . . . .
26
.
,
Amount
27 AMOUNT YOU OWE. Add line 24, line 25, and line 26. If line 23 is less than line 25 and
You Owe
line 26, enter the difference here. See instructions, page 9 (Do Not Send Cash). Mail to:
.
FRANCHISE TAX BOARD, PO BOX 942867, SACRAMENTO CA 94267-0001 . . . . . . . 27
,
Direct
28 REFUND OR NO AMOUNT DUE. Subtract line 25 and line 26 from line 23. See
Deposit
instructions, page 10. Mail to: FRANCHISE TAX BOARD, PO BOX 942840,
(Refund
.
Only)
SACRAMENTO CA 94240-0002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
,
Fill in the information to have your refund directly deposited to one or two separate accounts.
Do not attach a voided check or a deposit slip.
All or portion of total refund (line 28) you want to direct deposit:
Checking
.
,
Savings
Routing number
type
Account number
29
Amount you want to direct deposit
Remaining portion of total refund (line 28) you want to direct deposit:
Checking
.
,
Savings
Routing number
type
Account number
30
Amount you want to direct deposit
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.
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,
page 10.
Firm’s name (or yours if self-employed)
Firm’s address
FEIN
Side 2
Form 540 2EZ
2006
3112063
C1