California Form 540x - Amended Individual Income Tax Return - 2015 Page 2
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1
2
3Your name:
Your SSN or ITIN:
17 California income tax withheld . See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
18 Withholding (Form 592-B and/or 593) . See instructions . . . . . . . . . . . . . . . . . . . . . 18
19 Excess California SDI (or VPDI) withheld . See instructions . . . . . . . . . . . . . . .
.
19
20 Estimated tax payments and other payments . See instructions . . . . . . . . . . . .
.
20
21 Refundable Credits . See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . 21
Child and Dependent Care Expenses Credit (CDCE)
-
-
-
-
22 __________________________________
23 _________________
_________________
24 $
25 California Earned Income Tax Credit (EITC) . See instructions . . . . . . . . . . . . . . .
. . . .25
26 Tax paid with original tax return plus additional tax paid after it was filed . Do n
ot include penalties and interest . . . . . . . . . . . . . . . .
26
27 Total payments . Add lines 17, 18, 19, 20, 21, 25, and 26 of column C . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
27
28 Overpaid tax, if any, as shown on original tax return or as previously adjusted
by the FTB . See instructions . . . . . . . . . . . . . . . . . .
28
29 Subtract line 28 from line 27 . If line 28 is more than line 27 . See instructions
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
29
30 Use tax payments as shown on original tax return . See instructions . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
30
31 Voluntary contributions as shown on original tax return . See instructions . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
31
32 Subtract line 30 and line 31 from line 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
32
33 AMOUNT YOU OWE. If line 16, column C is more than line 32, enter the differ
ence
.
,
,
00
and see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
33
34 Penalties/Interest . See instructions: Penalties 34a______________________ Interest 34b______________________________
34c
.
,
,
00
35 REFUND. If line 16, column C is less than line 32, enter the difference . See instructions . . . . . . . . . . . . . . .
35
Part I
Nonresidents or Part-Year Residents Only
Attach and enter the amounts from your revised Short or Long Form 540NR and Schedule CA (540NR) . Your amended tax return cannot be processed without
this information .
1 Exemption amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
2 Federal adjusted gross income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. .
2
3 Adjusted gross income from all sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. .
3
4 Itemized deductions or standard deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. .
4
5 California adjusted gross income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. .
5
6 Tax from Schedule G-1 and form FTB 5870A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. .
6
7 Special credits and nonrefundable renter’s credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. .
7
8 Alternative minimum tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. .
8
9 Mental Health Services Tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. .
9
10 Other taxes and credit recapture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. .
1 0
Side 2 Form 540X
2015
C1
3152153
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