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FORM
A
California Resident Income Tax Return 2003
540
C1 Side 1
Step 1
Your first name
Initial
Last name
P
If joint return, spouse’s first name
Last name
Initial
Place
label here
AC
or print
___________
___________
___________
___________
___________
Present home address — number and street, PO Box, or rural route
Apt. no.
PMB no.
A
Name
and
State
ZIP Code
City, town, or post office (If you have a foreign address, see instructions)
R
Address
-
RP
Step 1a
Your social security number
Spouse’s social security number
IMPORTANT:
-
-
-
-
Your social security number
SSN
is required.
Step 2
1
Single
2
Married filing jointly (even if only one spouse had income)
Filing Status
3
Married filing separately. Enter spouse’s social security number above and full name here _______________________________
Fill in only one.
4
Head of household (with qualifying person). STOP. See instructions.
5
Qualifying widow(er) with dependent child. Enter year spouse died _________ .
Step 3
6 If your parent, (or someone else) can claim you (or your spouse, if married) as a dependent on his or her
¼
tax return, even if he or she chooses not to, fill in this circle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
Exemptions
For line 7, line 8, line 9, and line 10: Multiply the amount you enter in the box by the pre-printed dollar amount for that line.
Enclose, but do not
7
Personal: If you filled in 1, 3, or 4 above, enter 1 in the box. If you filled in 2 or 5, enter 2
staple, any payment.
X $82 =
$___________
in the box. If you filled in the circle on line 6, see
instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
X $82 =
$___________
8
Blind: If you (or if married, your spouse) are visually impaired, enter 1; if both, enter 2 . . . . . . . . . . . . . . .
8
¼
X $82 =
$___________
9
Senior: If you (or if married, your spouse) are 65 or older, enter 1; if both, enter 2 . . . . . . . . . . . . . . . .
9
10
Dependents: Enter name and relationship. Do not include yourself or your spouse.
Dependent
Exemptions
______________________ _______________________ ______________________
¼
X $257 =
$__________
______________________ _______________________ Total dependent exemptions . . . . . . . .
10
$__________
11
Exemption amount: Add line 7 through line 10. Transfer this amount to line 18 . . . . . . . . . . . . . . . . . . . .
11
Step 4
¼
. . . . .
, , , , ,
12 a State wages from your Form(s) W-2, box 16 . . . . . .
12a
Taxable
Income and
12 b
Enter federal adjusted gross income from your TeleFile Tax Record, line I; Form 1040EZ, line 4;
California
. . . . .
, , , , ,
12b
Form 1040A, line 21; or Form 1040, line 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Income
13 California Income Adjustments. See instructions for line 13a through line 13f.
Adjustments
a State income tax refund . . . . . . . . . . . . . . . . . . . . . . . . 13a
b Unemployment compensation . . . . . . . . . . . . . . . . . . . 13b
c U.S. Social security or railroad retirement . . . . . . . . . . 13c
Standard
d California nontaxable interest or dividend income . . . . 13d
Deduction
e California IRA distributions . . . . . . . . . . . . . . . . . . . . . . 13e
Single or
Married
f California pensions and annuities . . . . . . . . . . . . . . . . . 13f
¼
filing
. . . . .
, , , , ,
g Total California income adjustments. Add line 13a through line 13f . . . . . . . . . . . . . . . . .
13g
separately,
$3,070.
14 Subtract line 13g from line 12b. This is your California adjusted gross income.
¼
. . . . .
Married filing
, , , , ,
See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
jointly,
15 Enter the larger of your California Itemized deductions or Standard deduction
Head of
¼
. . . . .
household, or
, , , , ,
(see instructions). If the circle on line 6 is filled in, STOP. See instructions . . . . . . . . . . . . . .
15
Qualifying
widow(er),
. . . . .
$6,140.
, , , , ,
16 Subtract line 15 from line 14. This is your taxable income. If less than zero, enter -0- . . . . . . . 16
Step 5
. . . . .
, , , , ,
17 Tax. Fill in the circle if from:
Tax Table
Tax Rate Schedule . . . . . . . . . . . . . . . . . . 17
Tax and
18 Exemption credits. Enter the amount from line 11.
Credits
. . . . .
If line 12b is more than $135,714, see instructions. . . . . . . . . . . . . . . 18
, , , , ,
Attach copy of your
¼
. . . . .
Form(s) W-2, and
19 Nonrefundable renter’s credit. See instructions . . . . . . . . . . . . . . .
19
W-2G. Also attach
any Form(s) 1099
20 Total credits. Add line 18 and line 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
. . . . .
, , , , ,
showing California
tax withheld.
¼
23 Subtract line 20 from line 17. This is your total tax. If less than zero, enter -0- . . . . . . . . . . .
23
. . . . .
, , , , ,
540A03103