Form 540 2ez C1 - California Resident Income Tax Return - 2012
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1
2Get instructions for 540 2EZ Form
For Privacy Notice, get form FTB 1131.
FORM
California Resident Income Tax Return 2012
540 2EZ
C1 Side 1
Initial
Your first name
Last name
Your SSN or ITIN
P
-
-
AC
Initial
If joint 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.
R
City
State
ZIP Code
-
RP
Date
Taxpayer (mm/dd/yyyy) ______/______/___________
Spouse/RDP (mm/dd/yyyy) ______/______/___________
of
Birth
If you filed your 2011 tax return under a different last name, write the last name only from the 2011 tax return.
Prior
Name
Taxpayer _____________________________________________
Spouse/RDP_____________________________________________
Filing Status. Check the box for your filing status. See instructions, page 6.
Filing Status
1
m
Single
Check only one.
2
m
Married/RDP filing jointly (even if only one spouse/RDP had income)
4
m
Head of household. STOP! See instructions, page 6.
5
m
Qualifying widow(er) with dependent child. Year spouse/RDP died ______ .
m
If your California filing status is different from your federal filing status, check the box here. . . . . . . . . . . .
6 If another person can claim you (or your spouse/RDP) as a dependent on his or her tax return,
Exemptions
even if he or she chooses not to, you must see the instructions, page 6 . . . . . . . . . . . . . . . . . . . . . . . . . .
6
m
m
7 Senior: If you (or your spouse/RDP) are 65 or older, enter 1; if both are 65 or older, enter 2 . . . . . . . . . .
7
m
8 Dependents: (Do not include yourself or your spouse/RDP) Enter number of dependents here. . . . . . . .
8
Dependent’s relationship
First Name
Last Name
to you
Whole
only
dollars
9 Total wages (federal Form W-2, box 16).
Taxable
Income and
.
See instructions, page 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
,
0 0
Credits
.
10 Total interest income (Form 1099-INT, box 1). See instructions, page 7 . . . . . .
10
,
0 0
.
11 Total dividend income (Form 1099-DIV, box 1a). See instructions, page 7. . . . .
11
,
0 0
.
12 Total pension income ____________ See instructions, page 7. Taxable amount.
12
,
0 0
13 Total capital gains distributions from mutual funds (Form 1099-DIV, box 2a).
.
13
See instructions, page 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
,
0 0
14 Unemployment compensation . . . . . . . . . . . . . ▌ 14
.
,
0 0
▌ 15
.
15
U.S. social security or railroad retirement benefits .
,
0 0
Enclose, but do
16 Add line 9, line 10, line 11, line 12, and line 13. Do not include
not staple, any
.
line 14 and line 15. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16
,
0 0
payment.
17 Using the 2EZ Table for your filing status, enter the tax for the amount on line 16 . ▌ 17
.
,
0 0
Caution: If you check the box on line 6, STOP. See instructions, page 7,
Dependent Tax Worksheet.
18 Senior exemption: See instructions, page 7. If you are 65 and entered 1 in the
▌ 18
.
box on line 7, enter $104. If you entered 2 in the box on line 7, enter $208 . .
0 0
.
19 Nonrefundable renter’s credit. See instructions, page 8 . . . . . . . . . . . . . . . . . .
19
0 0
.
20 Credits. Add line 18 and line 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20
0 0
.
21 Tax. Subtract line 20 from line 17. If zero or less, enter -0- . . . . . . . . . . . . . . . .
21
,
0 0
(REV 12-12)
3111123
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