Print and Reset Form
Reset Form
Step 6
Your name: ___________________________________________ Your SSN: _____________________________
28 Amount from Side 1, line 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
28
Special
¼
31 Credit for joint custody head of household. See instructions . . . . . . . . . . . . .
31
Credits
¼
32 Credit for dependent parent. See instructions . . . . . . . . . . . . . . . . . . . . . . . . .
32
and
¼
33 Credit for senior head of household. See instructions . . . . . . . . . . . . . . . . . . .
33
Nonrefundable
¼
Renter’s
34 Credit for long-term care. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . .
34
¼
. . . . .
Credit
36 Credit percentage and credit amount. See instructions. Credit percentage 36a ___
___ ___ ___ ___ . . .
36
37 Enter credit name__________________code no ________and amount . . . . . . . . . . . . . . . . . . . . . . . . . . .
37
38 Enter credit name__________________code no ________and amount . . . . . . . . . . . . . . . . . . . . . . . . . . .
38
¼
39 To claim more than two credits, see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
39
¼
40 Nonrefundable renter’s credit. See instructions for “Step 6” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
40
42 Add line 36 through line 40. These are your total credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
42
43 Subtract line 42 from line 28. If less than zero, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
43
¼
Step 7
44 Alternative minimum tax. Attach Schedule P (540NR) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
44
¼
45 Other taxes and credit recapture. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
45
Other Taxes
¼
46 Add line 43 through line 45. This is your total tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
46
47 California income tax withheld. See instructions . . . . . . . . . . . . . . . . . . . . . . . .
47
Step 8
48 Nonresident withholding (Form(s) 592-B, 594, or 597). See instructions . . .
48
Payments
49 2003 CA estimated tax and other payments. See instructions . . . . . . . . . . . . . .
49
To view your
50 Excess SDI. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
50
estimated
Child and Dependent Care Expenses Credit. See instructions; attach form FTB 3506.
payments, go to
-
-
-
-
¼ ¼ ¼ ¼ ¼
¼ ¼ ¼ ¼ ¼
51 _________
______
_________
52 _________
______
_________
53 ____________________
54
55 Add line 47, line 48, line 49, line 50, and line 54. These are your total payments . . . . . . . . . . . . . . . . . . . . .
55
56 Overpaid tax. If line 55 is more than line 46, subtract line 46 from line 55 . . . . . . . . . . . . . . . . . . . . . . . . . .
56
Step 9
57 Amount of line 56 you want applied to your 2004 estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
57
Overpaid Tax
58 Overpaid tax available this year. Subtract line 57 from line 56 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
58
or Tax Due
59 Tax due. If line 55 is less than line 46, subtract line 55 from line 46 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
59
¼
¼
Step 10
00
00
CA Seniors Special Fund. See instructions . .
60
CA Breast Cancer Research Fund . . . . . . . . . . . . . . . .
65
¼
¼
00
00
Alzheimer’s Disease/Related Disorders Fund . . .
61
CA Firefighters’ Memorial Fund . . . . . . . . . . . . . . . . .
66
¼
¼
Contributions
00
00
CA Fund for Senior Citizens . . . . . . . . . . . . . .
62
Emergency Food Assistance Program Fund . . . . . . .
67
¼
00
Rare and Endangered Species
CA Peace Officer Memorial Foundation Fund . . . . . .
68
¼
¼
00
00
Preservation Program . . . . . . . . . . . . . . . .
63
Asthma and Lung Disease Research Fund . . . . . . . . . .
69
¼
00
State Children’s Trust Fund for the
CA Missions Foundation Fund . . . . . . . . . . . . . . . . . . .
70
¼
00
Prevention of Child Abuse . . . . . . . . . . . . .
64
¼
73 Add line 60 through line 70. These are your total contributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
73
Step 11
74 REFUND OR NO AMOUNT DUE. Subtract line 73 from line 58. Mail to:
. . . . .
, , , , ,
, , , , ,
FRANCHISE TAX BOARD, PO BOX 942840, SACRAMENTO CA 94240-0002 . . . .
74
Refund or
75 AMOUNT YOU OWE. Add line 59 and line 73. See instructions. Mail to:
Amount
. . . . .
You Owe
, , , , ,
, , , , ,
FRANCHISE TAX BOARD, PO BOX 942867, SACRAMENTO CA 94267-0001 . . . .
75
Step 12
76 Interest, late return penalties, and late payment penalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
76
77 Underpayment of estimated tax. Fill in circle:
FTB 5805 attached
FTB 5805F attached . . . .
77
Interest and
78 Total amount due. Enclose, but do not staple, any payment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
78
Penalties
¼
79 If you do not need California income tax forms mailed to you next year, fill in the circle . . . . . . . . . . . . . .
79
Do not attach a voided check or a deposit slip. See instructions.
Step 13
¼
Fill in the boxes to have your refund directly deposited. Routing number . . . . . . . . . . . . . . . .
Direct Deposit
Account Type:
(Refund Only)
Account
¼
Checking
Savings
¼
¼
number . . . . . . . . . .
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete.
3
Your signature
Daytime phone number (optional)
Sign
(
)
X
Here
Spouse’s signature (if filing jointly, both must sign)
X
I
t is unlawful to
Date
forge a spouse’s
Paid preparer’s signature (declaration of preparer is based on all information of which preparer has any knowledge)
Paid Preparer’s SSN/PTIN
¼
signature.
Joint return?
FEIN
Firm’s name (or yours if self-employed)
Firm’s address
¼
See instructions.
Side 2 Long Form 540NR
2003
NRL03203
C1