Form 540nr C1 - California Nonresident Or Part-Year Resident Income Tax Return - 2004
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California Nonresident or Part-Year
FORM
Long Form
540NR
Resident Income Tax Return 2004
C1 Side 1
Fiscal year filers only: Enter month of year end: month________ year 2005.
PBA Code
Your first name
Initial
Last name
P
Step 1
If joint return, spouse’s first name
Last name
Initial
Place
AC
label
here
Present home address — number and street, PO Box, or rural route
Apt. no.
PMB no.
or print
___________
___________
___________
___________
___________
A
Name
City, town, or post office (If you have a foreign address, see instructions, page 19)
State
ZIP Code
R
and
-
Address
RP
Your SSN or ITIN
Spouse’s SSN or ITIN
IMPORTANT:
Step 1a
-
-
-
-
Your SSN or ITIN
SSN or ITIN
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, page 19.
5
Qualifying widow(er) with dependent child. Enter year spouse died _________ .
6 If your parent (or someone else) can claim you (or your spouse, if married) as a dependent on his or her
Step 3
¼
tax return, even if he or she chooses not to, fill in this circle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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.
Exemptions
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
Enclose, but do not
staple, any payment.
X $85 = $_________
7
in the box. If you filled in the circle on line 6, see instructions, page 19 . . . . . . . . . . . . . . . . . . . . . . .
X $85 = $_________
8
8
Blind: If you (or if married, your spouse) are visually impaired, enter 1; if both, enter 2 . . . . . . . . .
¼
X $85 = $_________
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
____________________
____________________
______________________
¼
Exemptions
X $265= $_________
_____________________
_____________________ Total dependent exemptions . . . .
10
$
11
1 1
__________
Exemption amount: Add line 7 through line 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Step 4
¼
12 Total California wages from all your Form(s) W-2, box 16 . . . . . . . . . . . . . . . . . . . . .
12
Total
13 Enter federal adjusted gross income from Form 1040, line 36; Form 1040A, line 21;
Taxable
Income
Form 1040EZ, line 4; TeleFile Tax Record, line I; Form 1040NR, line 34; or Form 1040NR-EZ, line 10 . . . . . . 13
¼
Standard
14 California adjustments – subtractions. Enter the amount from Schedule CA (540NR), line 36, column B .
14
Deduction
15 Subtract line 14 from line 13. If less than zero, enter the result in parentheses. See instructions, page 20 . . . 15
¼
Single or Married
16 California adjustments – additions. Enter the amount from Schedule CA (540NR), line 36, column C . . . .
16
filing separately,
¼
17 Adjusted gross income from all sources. Combine line 15 and line 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17
$3,165
18 Enter the larger of: Your California itemized deductions from Schedule CA (540NR), line 42; OR
Married filing
¼
jointly, Head of
Your California standard deduction (see left margin). See instructions, page 20 . . . . . . . . . . . . . . . . . . . .
18
household, or
19 Subtract line 18 from line 17. This is your total taxable income. If less than zero, enter -0- . . . . . . . . . . . . . 19
Qualifying
widow(er), $6,330
20 Tax on the amount shown on line 19. Fill in the circle if from:
Step 5
¼
Tax Table
FTB 3800 or
FTB 3803 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20
California
Caution: If under age 14 and you have more than $1,600 of investment income. See inst., page 21.
Taxable
¼
21 CA adjusted gross income from Schedule CA (540NR), Part IV, line 44 . . . . .
21
Income
¼
22 CA Taxable Income from Schedule CA (540NR), Part IV, line 48 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
22
Attach copy of your
.
23 CA Tax Rate. Divide line 20 by line 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Form(s) W-2, W-2G,
24 CA Tax Before Exemption Credits. Multiply line 22 by line 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
592-B, 593-B,
and 594.
25a CA Exemption Credit Percentage. Divide line 22 by line 19. If more than 1, enter 1.0000 . . . . . . . . . . . . . . . . 25a
.
25b CA Prorated Exemption Credits. Multiply line 11 by line 25a. If the amount on line 13 is more than
Also attach any
Form(s) 1099
$139,921, see instructions, page 21. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25b
showing California tax
25c CA Regular Tax Before Credits. Subtract line 25b from line 24. If less than zero, enter -0- . . . . . . . . . . . . . . 25c
withheld.
26 Tax. Fill in circle if from:
Schedule G-1, Tax on Lump-Sum Distributions
¼
Form FTB 5870A, Tax on Accumulation Distribution of Trusts . . . . . . . . . .
26
¼
27 Add line 25c and line 26. Continue to Side 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
27
NRL04103
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