Form Ftb 4803e - Head Of Household Schedule - 2004 Page 2
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25. If your qualifying person did not live with you for the entire year during 2004, 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
A
Military service
B
Hospital / Convalescence
C
Birth or death
D
College
E
Lived with other parent
F
Code
Moved out
G
Other (please explain) __________________
H
6. Was your qualifying person in question 1 married as of December 31, 2004?
Yes
No
If yes, did this person file a joint tax return for 2004 with his or her spouse?
Yes
No
7. If your qualifying person was not your birth, adopted, or stepchild, did a parent of the qualifying person
live in the home with you and the qualifying person at any time during 2004?
Yes.
No.
8. As of December 31, 2004 were you single? For the purpose of this question “single” means: never
legally married, or widowed (spouse died before January 1, 2004), or received a final court decree of
divorce or legal separation on or before December 31, 2004, or received a final court decree of
annulment.
Yes.
No.
9. If you were legally married during all or part of 2004, did you live with your spouse at any time during
that year? You were legally married in 2004 if you did not receive a final court decree of divorce or legal
separation on or before December 31, 2004, or did not receive a final court decree of annulment.
Yes.
No.
If yes, list the beginning and ending dates of each period that you lived with your spouse during
2004.
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From
To
From
To
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From
To
From
To
Please provide a telephone number and the best time we can reach you between 6:30 a.m. and 7 p.m.
Monday through Friday, if we need more information.
___-___-____-____
Best time to call:
Telephone number:
____ Before ____ After ____ : ____ ____ a.m. ____ p.m.
(Area Code)
(Number)
(Extension)
FTB 4803e 2004
Page
2
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