Form 3520 - Ca Power Of Attorney - General Information

Form 3520 - Ca Power Of Attorney - General Information - 2015 Page 3

(714) 284-4802 ▪ (844) 327-6740 ▪ Fax (714) 254-7210 ▪ Website:

1100 E. Orangethorpe Ave., Suite 100, Anaheim, CA 92801

3. Form 8962 (Healthcare Tax): When entering the detail of individual health care

coverage on Form Coverage {64A}, zip 6 for detail of coverage or exemption

(required only when there is some but not full coverage for one or more family

member), you must always enter:

a) A code 2 (‘No’) in zip 1

b) Either an Exemption Certificate Number (issued by CoveredCA) or

An Other Exemption Type code on each line in zip 6 and

c) The period covered on each line in zip 6: Full Year or the specific months.

Do not check Full Year or enter the number of months and leave the exemption

section blank. When qualifying coverage applies, enter ‘X’ in the Other Exemption

Type and ‘X’ in Full Year or enter the beginning and ending months covered. In the

example below:

• Frank has coverage for the full year.

• Mary has coverage from June – December.

• Cecilia has an exemption for one short coverage gap up to 3 months; then she

has coverage for the rest of the year. She purchased insurance for April and

May and then her employer provided for the remainder of the year.

Note: Only one entry is required for Ceclia’s qualified coverage even though

it came from 2 different providers; no detail is required (yet).

4. 8962 {64B}: Do not enter the name of the insurance provider in zip 6 or 7; this goes

in zip 1 only. Zip 6 and 7 are for the Marketplace Identifier and the Marketplace

Assigned Policy Number from Form 1095-A lines 1 and 2. If the policy number is

more than 15 characters, enter the last 15 characters only. If you don’t have a Form

1095-A, you should not be submitting his form.

5. California Head of Household Form 3532: California now requires Form 3532

{CA42} for all Head of Household filers. This form will automatically be filled with

the basic default information when a code ‘6’ is entered in the State Use column of

the qualifying dependent on Form 1040, zip 65. A Procedure Charge will be applied

when an Error Control entry is required for this on an eFile return.

Form 3520 - Ca Power Of Attorney - General Information - 2015 Page 3