California Form 540x - Amended Individual Income Tax Return - 2004
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TAXABLE YEAR
CALIFORNIA FORM
Amended Individual Income Tax Return
540X
BE SURE TO COMPLETE AND SIGN SIDE 2
Fiscal year filers only: Enter the month and year end:
Your social security number
Last name
Your first name
Initial
P
-
-
Spouse’s social security number
If joint return, spouse’s first name
Initial
Last name
-
-
AC
Present home address — number and street, PO Box, or rural route
Apt. no.
PMB no.
A
State
ZIP Code
City, town, or post office
R
-
RP
a
Have you been advised that your original federal return has been, is being, or will be audited? . . . . . . . . . . . . . . . . . . . .
Yes
No
b
Filing status claimed.
On original return
Single
Married filing jointly
Married filing separately
Head of household
Qualifying widow(er)
On this return
Single
Married filing jointly
Married filing separately
Head of household
Qualifying widow(er)
¼
c
If at the time you are amending, you (or your spouse, if married) can be claimed as a dependent on someone else’s tax return, fill in this circle
d
If claiming head of household, enter name and relationship of qualifying person on: Original return ______________ Amended return ______________
Note: If you are amending Form 540NR, see General Information D before continuing. If
A.
B.
C.
As originally reported/
Net change:
Correct amount
you are amending Forms 540 2EZ or 540TEL, see the instructions for lines 1
adjusted by FTB.
Explain on Side 2
through 6.
See instructions
¼
1a
1 a State wages. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a
1b
b Federal AGI. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1b
2 CA adjustments. See specific instructions on Form 540A or Sch. CA (540 or 540NR).
2a
a California nontaxable interest income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a
2b
b State income tax refund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2b
2c
c Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2c
2d
d Social Security benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2d
2e
e Other (list)__________________________________________________ . . 2e
¼
3
3 Total California adjustments. Combine line 2a through line 2e. See instructions . 3
¼
4
4 California adjusted gross income. Combine line 1b and line 3. See instructions . 4
¼
5
5 California itemized deductions or California standard deduction. See instructions 5
¼
6
6 Taxable income. Subtract line 5 from line 4. If less than zero, enter -0- . . . . . .
6
¼
TT
FTB 3800
FTB 3803
7a
7 a Tax method used for Column C. See instructions . . . . . . . . . . . . . . . . . . . . . . . . .
¼
7b
b Tax. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7b
¼
8
8 Exemption credits. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
9
9 Subtract line 8 from line 7b. If less than zero, enter -0- . . . . . . . . . . . . . . . . . . . . 9
¼
10
10 Tax from Schedule G-1 and form FTB 5870A. See instructions . . . . . . . . . . . . . . . 10
11
11 Add line 9 and line 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
¼
12
12 Special credits and nonrefundable renter’s credit. See instructions . . . . . . . . . . . 12
13
13 Subtract line 12 from line 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
¼
14
14 Other taxes (alternative minimum tax, credit recapture, etc.). See instructions . . 14
¼
15
15 Total tax. Add line 13 and line 14. If amending Form 540NR, see instructions . . . 15
16
16 California income tax withheld. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . 16
17
17 California real estate or nonresident withholding. See instructions . . . . . . . . . . . . 17
18
18 Excess California SDI (or VPDI) withheld. See instructions . . . . . . . . . . . . . . . . . 18
19
19 Estimated tax payments and other payments. See instructions . . . . . . . . . . . . . . 19
20
20 Child and Dependent Care Expenses or Other Refundable Credits. See inst. . . . . 20
¼
¼
21 __________________________________
22 ________________________________
23 $ ____________________
24 Tax paid with original return plus additional tax paid after it was filed. Complete Side 2, Part I before entering amount here . . . . .
24
25 Total payments. Add lines 16, 17, 18, 19, 20, and 24 of column C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
25
540X04103
Form 540X
2004 Side 1
For Privacy Act Notice, get form FTB 1131.
C1
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