Head Of Household Schedule (Ftb 4803e) - 2013 printable pdf download

2013 Head of Household Schedule (FTB 4803e)

Use the chart below to identify the relationship of the person you believe qualified you for the head of

household filing status. Enter the code number of that relationship in the code box to the right. You must

have a qualifying person to qualify for the head of household filing status. You may not claim yourself,

your spouse/registered domestic partner (RDP), or your tax preparer as your qualifying person.

Relationship

Code

Son, daughter, stepson, or stepdaughter

Grandchild, brother, sister, half brother, half sister, stepbrother,

stepsister, nephew, or niece

Eligible foster child

Father, mother, stepfather, or stepmother

Grandfather, grandmother, son-in-law, daughter-in-law, father-in-law,

Code

mother-in-law, brother-in-law, sister-in-law, uncle, or aunt

Other (please explain)

Provide the social security number, name, and age of the qualifying person you indicated in Question 1.

Social security number: __________________ Name: _____________________________

Age in years as of 12/31/2013: _________ If less than one year old, age in months: _____

Was your qualifying person’s gross income less than $3,900 in 2013?

Yes

Did you provide more than half the support for your qualifying person in 2013?

Yes

Was your qualifying person a full-time student at a recognized educational institution for at least five

months during 2013?

Yes

Did your qualifying person live with you the entire year in 2013?

Yes. Go to Question 8.

No. List the beginning and ending dates of each period your qualifying person lived with you during

2013, or provide the total number of days your qualifying person lived with you during 2013, and

then answer Question 7.

From: ___________ To: ______________

Total number of days

(More than 12 hours each day)

From: ___________ To: ______________

If your qualifying person did not live with you for the entire year during 2013, select the code below that

best explains the main reason your qualifying person was absent from your home. Enter the code letter in

the code box to the right.

Main Reason

Code

Lived away at school

Military service

FTB 4803e (REV 07-2013)

PAGE 1

Head Of Household Schedule (Ftb 4803e) - 2013