Form 540a C1 - California Resident Income Tax Return - 2012
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FORM
A
California Resident Income Tax Return 2012
540
C1 Side 1
Last name
Initial
Your first name
Your SSN or ITIN
P
AC
Last name
Initial
If joint tax return, spouse’s/RDP’s first name
Spouse’s/RDP’s SSN or ITIN
A
Address (number and street, PO Box, or PMB no.)
Apt. no/Ste. no.
R
City (If you have a foreign address, see page 7.)
State
ZIP Code
RP
Your DOB (mm/dd/yyyy) ______/______/___________
Spouse’s/RDP’s DOB (mm/dd/yyyy) ______/______/___________
If you filed your 2011 tax return under a different last name, write the last name only from the 2011 tax return .
Taxpayer _______________________________________________
Spouse/RDP_____________________________________________
1
Single
4
Head of household (with qualifying person) (see page 3)
2
Married/RDP filing jointly (see page 3)
5
Qualifying widow(er) with dependent child . Enter year spouse/RDP died __________
3
Married/RDP filing separately . Enter spouse’s/RDP’s SSN or ITIN above and full name here____________________________________________
If your California filing status is different from your federal filing status, check the box here . . . . . . . . . . . . . . . . . . . .
6
If someone can claim you (or your spouse/RDP) as a dependent, check the box here (see page 7) . . . . . . . . . . . . . .
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 .
Whole dollars only
7 Personal: If you checked box 1, 3, or 4 above, enter 1 in the box . If you checked box 2 or 5, enter 2 in the box .
X $104 = $
If you checked the box on line 6, see page 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
_______________
X $104 = $
8 Blind: If you (or your spouse/RDP) are visually impaired, enter 1; if both are visually impaired, enter 2 . . . . 8
_______________
▌
X $104 =
$
9 Senior: If you (or your spouse/RDP) are 65 or older, enter 1; if both are 65 or older, enter 2 . . . . . . . .
9
_______________
10 Dependents: Do not include yourself or your spouse/RDP.
Dependent’s
First name
Last name
relationship to you
▌
X $321 =
$
Total dependent exemptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
_______________
$
11 Exemption amount: Add line 7 through line 10 . Transfer this amount to line 32 . . . . . . . . . . . . . . . . . . . . 11
_______________
.
00
,
,
12 State wages from your Form(s) W-2, box 16 . . . . . . . . . . . . . . .
12
.
00
,
,
13 Enter federal adjusted gross income from Form 1040, line 37; 1040A, line 21; or 1040EZ, line 4 . . . . . . . . . . . 13
14 California Income Adjustments. See pages 8 and 9 for line 14a through line 14f .
▌
00
a State income tax refund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14a
▌
00
b Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . .
14b
▌
00
c U .S . social security or railroad retirement . . . . . . . . . . . . . . . . .
14c
▌
00
d California non-taxable interest or dividend income . . . . . . . . . . .
14d
▌
00
e California IRA distributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14e
▌
00
f Non-taxable pensions and annuities . . . . . . . . . . . . . . . . . . . . . .
14f
.
00
,
,
g Total California income adjustments . Add line 14a through line 14f . . . . . . . . . . . . . . . . . . . . . . . . . . .
14g
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00
,
,
17 Subtract line 14g from line 13 . This is your California adjusted gross income . . . . . . . . . . . . . . . . . . . . . .
17
18 Enter the larger of your California itemized deductions or standard deduction for your filing status
• Single or Married/RDP filing separately . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $3,841
• Married/RDP filing jointly, Head of household, or Qualifying widow(er) . . . . . . . . . . . $7,682
.
00
,
,
If the box on line 6 is checked, STOP (see page 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18
.
00
▌
,
,
19 Subtract line 18 from line 17 . This is your taxable income . If less than zero, enter -0- . . . . . . . . . . . . . . .
19
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