SCHEDULE
TAXABLE YEAR
CA (540)
2012
California Adjustments — Residents
Important: Attach this schedule behind Form 540, Side 3 as a supporting California schedule.
Name(s) as shown on tax return
SSN or ITIN
Part I Income Adjustment Schedule
Federal Amounts
Subtractions
Additions
A
B
C
(taxable amounts from
See instructions
See instructions
Section A – Income
your federal tax return)
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7
Wages, salaries, tips, etc. See instructions before making an entry in column B or C . . . . 7
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8
Taxable interest (b)________________________. . . . . . . . . . . . . . . . . . . . . . . . . . . . .8(a)
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9
Ordinary dividends. See instructions. (b) ________________________ . . . . . . . . . . .9(a)
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10
Taxable refunds, credits, offsets of state and local income taxes . . . . . . . . . . . . . . . . . . . 10
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11
Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
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12
Business income or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
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13
Capital gain or (loss). See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
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14
Other gains or (losses) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
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15
IRA distributions. See instructions. (a) ____________________ . . . . . . . . . . . . . . . .15(b)
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16
Pensions and annuities. See instructions. (a) ____________________ . . . . . . . . . . .16(b)
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17
Rental real estate, royalties, partnerships, S corporations, trusts, etc.. . . . . . . . . . . . . . . 17
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18
Farm income or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
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19
Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
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{
20
Social security benefits (a)
___________________ . . . . . . . . . . . . . . . . . . . . . . . . .20(b)
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21
Other income.
a
a
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a California lottery winnings
e NOL from FTB 3805D, 3805Z,
b
b
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b Disaster loss carryover from FTB 3805V
3806, 3807, or 3809
21
c _____________
c
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c Federal NOL (Form 1040, line 21)
f Other (describe):
d
d
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d NOL carryover from FTB 3805V
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e
e
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_______________________
f
f
22
Total. Combine line 7 through line 21 in column A. Add line 7 through line 21f in
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column B and column C. Go to Section B. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Section B – Adjustments to Income
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23
Educator expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
24
Certain business expenses of reservists, performing artists, and fee-basis
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government officials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
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25
Health savings account deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
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26
Moving expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
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27
Deductible part of self-employment tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
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28
Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
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29
Self-employed health insurance deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
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30
Penalty on early withdrawal of savings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
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31a Alimony paid. (b) Recipient’s: SSN
___ ___ ___ – ___ ___ – ___ ___ ___ ___
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Last name
_____________________________ . . . . 31a
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32
IRA deduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
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33
Student loan interest deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
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34
Tuition and fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
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35
Domestic production activities deduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
36
Add line 23 through line 31a and line 32 through line 35 in columns A, B, and C.
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See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
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37
Total. Subtract line 36 from line 22 in columns A, B, and C. See instructions . . . . . . . . 37
Schedule CA (540) 2012 Side 1
7731123
For Privacy Notice, get form FTB 1131.