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For Privacy Notice, get form FTB 1131.
FORM
California Resident Income Tax Return 2011
540 2EZ
C1 Side 1
Initial
Your first name
Last name
Your SSN or ITIN
P
-
-
AC
Initial
If joint return, spouse’s/RDP’s first name
Last name
Spouse’s/RDP’s SSN or ITIN
-
-
A
Address (number and street, PO Box, or PMB no.)
Apt. no./Ste. no.
R
City
State
ZIP Code
-
RP
Date
taxpayer (mm/dd/yyyy) ______/______/___________
Spouse/RDP (mm/dd/yyyy) ______/______/___________
of
Birth
If you filed your 2010 tax return under a different last name, write the last name only from the 2010 tax return.
Prior
Name
taxpayer _____________________________________________
Spouse/RDP_____________________________________________
Filing Status. Fill in the circle for your filing status. See instructions, page 6.
Filing Status
1
Single
Fill in only one.
2
Married/RDP filing jointly (even if only one spouse/RDP had income)
4
Head of household. StoP! See instructions, page 6.
5
Qualifying widow(er) with dependent child. Year spouse/RDP died ______ .
If your California filing status is different from your federal filing status, fill in the circle here . . . . . . . . . . .
6 If another person can claim you (or your spouse/RDP) as a dependent on his or her tax return,
Exemptions
even if he or she chooses not to, you must see the instructions, page 6 . . . . . . . . . . . . . . . . . . . . . . . . . .
6
m
7 Senior: If you (or your spouse/RDP) are 65 or older, enter 1; if both are 65 or older, enter 2 . . . . . . . . . .
7
m
8 Number of dependents. Enter name and relationship (Do not include yourself or your spouse/RDP). . . .
8
Dependent
Exemptions
________________________________
________________________________
______________________________
Whole
only
dollars
9 total wages (federal Form W-2, box 16).
Taxable
Income and
.
See instructions, page 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
,
0 0
Credits
.
10 total interest income (Form 1099-INt, box 1). See instructions, page 7 . . . . . .
10
,
0 0
.
11 total dividend income (Form 1099-DIV, box 1a). See instructions, page 7. . . . .
11
,
0 0
.
12 total pension income ____________ See instructions, page 7. taxable amount.
12
,
0 0
13 total capital gains distributions from mutual funds (Form 1099-DIV, box 2a).
.
See instructions, page 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
,
0 0
.
14 Unemployment compensation . . . . . . . . . . . .
14
,
0 0
Enclose, but do
.
,
15
15
0 0
U.S. social security or railroad retirement benefits .
not staple, any
16 Add line 9, line 10, line 11, line 12, and line 13. Do not include
payment.
0
.
line 14 and line 15. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16
,
0 0
.
17 Using the 2EZ table for your filing status, enter the tax for the amount on line 16 . 17
,
0 0
Caution: If you filled in the circle on line 6, STOP. See instructions, page 7,
Dependent tax Worksheet.
18 Senior exemption: See instructions, page 7. If you are 65 and entered 1 in the
0
.
0 0
box on line 7, enter $102. If you entered 2 in the box on line 7, enter $204 . . . .
18
.
0 0
19 Nonrefundable renter’s credit. See instructions, page 8 . . . . . . . . . . . . . . . . . .
19
0
.
0 0
20 Credits. Add line 18 and line 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20
0
.
21 Tax. Subtract line 20 from line 17. If zero or less, enter -0- . . . . . . . . . . . . . . . .
21
,
0 0
3111113
9