TAXABLE YEAR
CALIFORNIA FORM
Amended Individual Income Tax Return
540X
BE SURE TO COMPLETE AND SIGN SIDE 3
Fiscal year filers only: Enter month of year end and year (mm/yyyy) ________________.
Your first name
Initial
Last name
Your SSN or ITIN
A
Spouse’s/RDP’s SSN or ITIN
Initial
Last name
If joint tax return, spouse’s/RDP’s first name
R
Additional information (See instructions)
PBA Code
RP
Street address (Number and street or PO Box)
Apt. no./Ste. no.
PMB/Private Mailbox
State
ZIP Code
City (If you have a foreign address, see page 2)
Foreign Country Name
Foreign Province/State/County
Foreign Postal Code
m
m
a
Have you been advised that your original federal tax return has been, is being, or will be audited? . . . . . . . . . . . . . . . .
Yes
No
b
Filing status claimed on:
m
m
m
m
m
Original tax return
Single
Married/RDP filing jointly
Married/RDP filing separately
Head of household
Qualifying widow(er)
m
m
m
m
m
Amended tax return
Single
Married/RDP filing jointly
Married/RDP filing separately
Head of household
Qualifying widow(er)
m
c
If for the year you are amending, you (or your spouse/RDP) can be claimed as a dependent on someone else’s tax return, check this box . . . . . . . . . .
d
If claiming head of household, enter name and relationship of qualifying person on:
Original tax return
Amended tax return
A.
B.
C.
If amending Form 540NR, see General Information D .
As originally reported/
Net change
Correct amount
If amending Forms 540 2EZ, 540, or 540A, see the instructions for lines 1 through 6 .
adjusted by the FTB
Explain on Side 2,
All filers: Explain changes on Side 3 and attach your supporting documents .
See instructions
Part ll, line 5
1 a State wages . See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a
b Federal adjusted gross income . See instructions . . . . . . . . . . . . . . . . . . . . . . . . 1b
2 CA adjustments . Get specific instructions on Form 540A or Sch . CA (540) .
a California nontaxable interest income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a
b State income tax refund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2b
c Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2c
d Social Security benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2d
e Other (list)__________________________________________________ . . . . 2e
3 Total California adjustments . Combine line 2a through line 2e . See instructions . . . . 3
4 California adjusted gross income . Combine line 1b and line 3 . See instructions . . . . 4
5 California itemized deductions or California standard deduction . See instructions . . 5
6 Taxable income . Subtract line 5 from line 4 . If less than zero, enter -0- . . . . . . .
6
m
m
m
7 a Tax method used for line 7b, column C . See instructions . . . . . . . . . . . . . . .
7a
TT
FTB 3800
FTB 3803
b Tax . See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7b
8 Exemption credits . See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
9 Subtract line 8 from line 7b . If less than zero, enter -0- . . . . . . . . . . . . . . . . . . . . . . . 9
10 Tax from Schedule G-1 and form FTB 5870A . See instructions . . . . . . . . . . . . . . . . 10
11 Add line 9 and line 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
12 Special Credits and Nonrefundable Credits . See instructions . . . . . . . . . . . . . . . . . . 12
13 Subtract line 12 from line 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
14 Other taxes (alternative minimum tax, credit recapture, etc .) . See instructions . . . . 14
15 Mental Health Services Tax . See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
16 Total tax . Add line 13, line 14, and line 15 .
If amending Form 540NR . See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Form 540X
2013 Side 1
3151133
C1
For Privacy Notice, get FTB 1131 ENG/SP.