Form 540 2ez - California Resident Income Tax Return - 2004
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FORM
California Resident Income Tax Return 2004
540 2EZ
C1 Side 1
Last name
Your first name
Initial
P
Step 1
If joint return, spouse’s first name
Last name
Initial
Place
label here
or print
AC
___________
___________
___________
___________
___________
Apt. no.
PMB no.
Number and street, PO Box, or rural route
Name
A
and
State
ZIP Code
City, town, or post office
Address
-
R
Your SSN or ITIN
Spouse’s SSN or ITIN
Step 1a
IMPORTANT:
RP
-
-
-
-
Your SSN or ITIN
SSN or ITIN
is required.
Filing Status. Fill in the circle for your filing status. See instructions, page 5.
Step 2
1
Single
Filing Status
2
Married filing jointly (even if only one spouse had income)
Fill in only one.
4
Head of household. STOP! See instructions, page 5.
5
Qualifying widow(er) with dependent child. Year spouse died ______ .
Step 3
6 If another person can claim you (or your spouse, if married) as a dependent on his or her tax return,
¼ ¼ ¼ ¼ ¼
even if he or she chooses not to, fill in this circle. See instructions, page 6 . . . . . . . . . . . . . . . . . . . . . . .
6
Exemptions
¼ ¼ ¼ ¼ ¼
7 Senior: If you (or if married, your spouse) are 65 or older, enter 1; if both, enter 2 . . . . . . . . . . . . . .
7
¼ ¼ ¼ ¼ ¼
8 Number of dependents. (Do not include yourself or your spouse). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
Dependent
Exemptions
Name:____________________________ Name:_____________________________ Name:_____________________________
Step 4
9 Total wages (Form W-2, box 16). See instructions, page 6 . . . . . . . . . . . . . . . ¼ ¼ ¼ ¼ ¼
. . . . .
9
,
Taxable
Income and
. . . . .
Credits
10a Total interest income (Form 1099-INT, box 1). See instructions, page 6 . . .
10a
,
. . . . .
,
10b Total dividend income (Form 1099-DIV, box 1). See instructions, page 6 . . . . . 10b
,
. . . . .
,
10c Total pensions ____________ See instructions, page 7. Taxable amount. . . . . 10c
. . . . .
11 Unemployment compensation . . . . . . . . . . .
11
,
. . . . .
12 U.S. Social security or railroad retirement . .
12
,
Enclose, but do
not staple, any
13 Add line 9, line 10a, line 10b, and line 10c.
payment.
¼ ¼ ¼ ¼ ¼
. . . . .
Caution: Do not include line 11 and line 12 . . . . . . . . . . . . . . . . . . . . . . . . . .
13
,
. . . . .
14 Using the 2EZ Table for your filing status, enter the tax for the amount on line 13. . . 14
,
(If you filled in the circle on line 6, STOP. See instructions, page 6.)
15 Senior Exemption: See instructions on page 7. If you are 65 and entered 1 in the
. . . . .
box on line 7, enter $85. If you entered 2 in the box on line 7, enter $170 . . . .
15
¼ ¼ ¼ ¼ ¼
. . . . .
16 Nonrefundable renter’s credit. See instructions, page 7 . . . . . . . . . . . . . . . . .
16
. . . . .
. . . . .
17 Add line 15 and line 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17
¼ ¼ ¼ ¼ ¼
. . . . .
18 Subtract line 17 from line 14. If zero or less, enter -0- . . . . . . . . . . . . . . . . . .
18
,
Step 5
. . . . .
19 Total tax withheld (Form W-2, box 17 and/or Form 1099-R, box 10) . . . . . . . .
19
,
Overpaid
Tax/ Tax Due
. . . . .
20 Overpaid tax. If line 19 is more than line 18, subtract line 18 from line 19 . . . .
20
,
Attach a copy of
your Form(s) W-2.
21 Tax due. If line 19 is less than line 18, subtract line 19 from line 18.
. . . . .
See instructions, page 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
,
2EZ04103
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