Form 540nr - California Nonresident Or Part-Year Resident Income Tax Return - 2016
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4California Nonresident or Part-Year
FORM
TAXABLE YEAR
2016
540NR
Resident Income Tax Return
Long Form
Fiscal year filers only: Enter month of year end: month ________ year 2017.
A
Your first name
Initial
Last name
Suffix
Your SSN or ITIN
-
-
R
If joint tax return, spouse’s/RDP’s first name
Last name
Suffix
Spouse’s/RDP’s SSN or ITIN
Initial
-
-
RP
Additional information (See instructions)
PBA code
Street address (number and street) or PO box
Apt. no./ste. no.
PMB/private mailbox
City (If you have a foreign address, see instructions)
State
ZIP code
-
Foreign country name
Foreign province/state/county
Foreign postal code
Your DOB (mm/dd/yyyy) ______/______/___________
Spouse’s/RDP’s DOB (mm/dd/yyyy) ______/______/___________
If you filed your 2015 tax return under a different last name, write the last name only from the 2015 tax return.
Taxpayer ______________________________________________
Spouse/RDP _____________________________________________
1
Single
4
Head of household (with qualifying person). See instructions.
2
Married/RDP filing jointly. See inst.
5
Qualifying widow(er) with dependent child. Enter year spouse/RDP died _________
3
Married/RDP filing separately. Enter spouse’s/RDP’s SSN or ITIN above and full name here______________________________________
If your California filing status is different from your federal filing status, check the box here . . . . . . . . . . . .
6 If someone can claim you (or your spouse/RDP) as a dependent, check the box here. See inst . . . . . . . .
6
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.
Whole dollars only
7 Personal: If you checked box 1, 3, or 4 above, enter 1 in the box. If you checked box 2 or 5,
X $111 = $
enter 2. If you checked the box on line 6, see instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
_________________
8 Blind: If you (or your spouse/RDP) are visually impaired, enter 1;
X $111 = $
if both are visually impaired, enter 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
_________________
X $111 = $
9 Senior: If you (or your spouse/RDP) are 65 or older, enter 1; if both are 65 or older, enter 2 .
9
_________________
10
Dependents: Do not include yourself or your spouse/RDP.
Dependent 1
Dependent 2
Dependent 3
First Name
Last Name
SSN
Dependent's
relationship
to you
X $344 = $
Total dependent exemptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
$
11 Exemption amount: Add line 7 through line 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
12 Total California wages from your Form(s) W-2, box 16 . . . . . . . . . . . . . . . . . . . . . .
12
00
13 Enter federal AGI from Form 1040, line 37; 1040A, line 21; 1040EZ, line 4; 1040NR, line 36;
or 1040NR-EZ, line 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
00
14 California adjustments – subtractions. Enter the amount from Schedule CA (540NR), line 37, column B . . . . .
14
00
15 Subtract line 14 from line 13. If less than zero, enter the result in parentheses. See instructions . . . . . . . . . . . . . . 15
00
16 California adjustments – additions. Enter the amount from Schedule CA (540NR), line 37, column C. . . . . . . .
16
00
17 Adjusted gross income from all sources. Combine line 15 and line 16. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17
00
18 Enter the larger of: Your California itemized deductions from Schedule CA (540NR), line 44; OR
Your California standard deduction. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18
00
19 Subtract line 18 from line 17. This is your total taxable income. If less than zero, enter -0-. . . . . . . . . . . . . . .
19
00
Long Form 540NR
2016 Side 1
3131163
C1
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