Form 540nr - California Nonresident Or Part-Year Resident Income Tax Return - 2001

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California Nonresident or Part-Year

FORM

540NR

Resident Income Tax Return 2001

Short Form

Your first name

Initial

Last name

Step 1

Last name

If joint return, spouse’s first name

Initial

Place

label

here

Present home address — number and street, PO Box or rural route

Apt. no.

PMB no.

or print

___________

Name

State

ZIP Code

City, town, or post office

and

Address

Your social security number

Spouse’s social security number

IMPORTANT:

Step 1a

Your social security number

SSN

is required.

Single

State of residence

Step 2

Step 2a

Married filing joint

Taxpayer________________ Spouse_______________

Filing Status

Residency

(even if only one spouse had income)

Dates of residency

Head of household

Fill in only one.

Taxpayer from________________ to_______________

(with qualifying person). STOP. See instructions.

Spouse from ________________ to_______________

Qualifying widow(er) with dependent child.

Active duty military – State of domicile

Enter year spouse died _________ .

Taxpayer________________ Spouse_______________

Step 3

6 If your parent (or someone else) can claim you (or your spouse, if married) as a dependent on his or her

tax return, even if he or she chooses not to, fill in this circle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Exemptions

For line 7, line 8, and line 11: Multiply the amount you enter in the box by the pre-printed dollar amount for that line.

Attach check or

money order here.

7 Personal: If you filled in 1 or 4 above, enter 1 in the box. If you filled in 2 or 5, enter 2

X $79 = $_________

in the box. If you filled in the circle on line 6, see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

X $79 = $_________

8 Blind: If you (or if married, your spouse) are visually impaired, enter 1; if both, enter 2 . . . . . . . . . . . 8

10 Add line 7 and line 8. This is your total exemption credit before the dependent

$_________

exemption credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Total

Dependent

11 Dependents: Enter name and relationship. Do not include yourself or your spouse.

Exemptions

______________________ _______________________ ______________________

X $247 = $________

Total dependent exemption credit . . . .

______________________ _______________________

Step 4

12 Total California wages from all your Form(s) W-2, box 16 . . . . . . . . . . . . . . . . . . . . .

13 Enter federal adjusted gross income from Form 1040, line 33; Form 1040A, line 19;

Taxable

Form 1040EZ, line 4; TeleFile Tax Record, line I; Form 1040NR, line 33; or Form 1040NR-EZ, line 10 . . . . . . . 13

Income

Standard

14 Unemployment compensation and military pay adjustment. See instructions . . . . . . . . . . . . . . . . . . . . . . .

Deduction

Single,

17 Adjusted gross income from all sources. Subtract line 14 from line 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$2,960

Married filing

18 Standard deduction for your filing status (see the left margin). If you filled in the circle on line 6,

joint, Head of

household, or

see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Qualifying

widow(er),

$5,920

19 Subtract line 18 from line 17. This is your taxable income. If less than zero, enter -0- . . . . . . . . . . . . . . . . . . . 19

22 Tax on the amount shown on line 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Step 5

23 Exemption credits. Add line 10 and line 11 and enter the result on line 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Tax

24 Subtract line 23 from line 22. If less than zero, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

25 Add California wages from line 12 and taxable interest (Form 1099, box 1,

Attach a copy of

see instructions). This is your California adjusted gross income . . . . . . . . . . . . . . . .

your Form(s) W-2

25a Ratio. Divide the amount on line 25 by the amount on line 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25a

and 1099(s)

showing

27 Multiply line 24 (tax) by line 25a (ratio) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

California tax

withheld

NRS01109

Short Form 540NR

2001 Side 1

For Privacy Act Notice, get form FTB 1131.