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FORM
California Resident Income Tax Return 2012
540
C1 Side 1
Fiscal year filers only: Enter month of year end: month________ year 2013.
Initial
Your first name
Last name
Your SSN or ITIN
P
AC
Initial
If joint tax return, spouse’s/RDP’s first name
Last name
Spouse’s/RDP’s SSN or ITIN
A
Address (number and street, PO Box, or PMB no.)
Apt. no./Ste. no.
PBA Code
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,
X $104 =
$
enter 2, in the box . If you checked the box on line 6, see page 7 . . . . . . . . . . . . . . . . . . . . . . . . . . 7
_________________
8 Blind: If you (or your spouse/RDP) are visually impaired, enter 1;
X $104 =
$
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
_________________
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
00
14 California adjustments – subtractions . Enter the amount from Schedule CA (540), line 37, column B . . . . . . .
14
00
15 Subtract line 14 from line 13 . If less than zero, enter the result in parentheses (see page 9) . . . . . . . . . . . . . . . . . 15
00
16 California adjustments – additions . Enter the amount from Schedule CA (540), line 37, column C . . . . . . . . . .
16
00
17 California adjusted gross income . Combine line 15 and line 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
{
17
00
{
18 Enter the
Your California itemized deductions from Schedule CA (540), line 44; OR
larger of:
Your California standard deduction shown below 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
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
00
3101123