For Privacy Notice, get FTB 1131 ENG/SP.
California Nonresident or Part-Year
FORM
540NR
Resident Income Tax Return 2013
Long Form
C1 Side 1
Fiscal year filers only: Enter month of year end: month________ year 2014.
Your SSN or ITIN
Initial
A
Your first name
Last name
R
Spouse’s/RDP’s SSN or ITIN
Initial
Last name
If joint tax return, spouse’s/RDP’s first name
RP
Additional information (see instructions)
PBA Code
Street address (number and street or PO Box)
Apt. no./Ste. no.
PMB/Private Mailbox
State
ZIP Code
City (If you have a foreign address, see page 9)
Foreign Country Name
Foreign Province/State/County
Foreign Postal Code
Your DOB (mm/dd/yyyy) ______/______/___________
Spouse’s/RDP’s DOB (mm/dd/yyyy) ______/______/___________
If you filed your 2012 tax return under a different last name, write the last name only from the 2012 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 17) . . . .
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 $106 =
$
enter 2 . If you checked the box on line 6, see page 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
_________________
8 Blind: If you (or your spouse/RDP) are visually impaired, enter 1;
X $106 =
$
if both are visually impaired, enter 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
_________________
X $106 = $
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 $326 = $
Total dependent exemptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
__________________
$
11 Exemption amount: Add line 7 through line 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
__________________
12 Total California wages from your Form(s) W-2, box 16 . . . . . . . . . . . . . . . . . . . . . .
12
00
13
. . . . 13
00
Enter federal AGI from Form 1040, line 37; 1040A, line 21; 1040EZ, line 4; 1040NR, line 36; or 1040NR-EZ, line 10
14 California adjustments – subtractions . Enter the amount from Schedule CA (540NR), line 37, column B . . . . .
14
00
15 Subtract line 14 from line 13 . If less than zero, enter the result in parentheses (see page 18) . . . . . . . . . . . . . . . . . 15
00
16 California adjustments – additions . Enter the amount from Schedule CA (540NR), line 37, column C . . . . . . . .
16
00
17 Adjusted gross income from all sources . Combine line 15 and line 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17
00
18 Enter the larger of: Your California itemized deductions from Schedule CA (540NR), line 43; OR
Your California standard deduction (see page 18) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18
00
19 Subtract line 18 from line 17 . This is your total taxable income . If less than zero, enter -0- . . . . . . . . . . . . . .
19
00
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