Short Form 540nr - California Nonresident Or Part-Year Resident Income Tax Return - 2013

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California Nonresident or Part-Year
FORM
Short Form
540NR
Resident Income Tax Return 2013
C1 Side 1
Initial
Your first name
Last name
Your SSN or ITIN
A
R
Initial
If joint tax return, spouse’s/RDP’s first name
Last name
Spouse’s/RDP’s SSN or ITIN
RP
Additional information (See instructions)
Street address (Number and street or PO Box)
Apt. no./Ste. no.
PMB/Private Mailbox
City (If you have a foreign address, see page 9)
State
ZIP Code
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 _________
If your California filing status is different from your federal filing status, check the box here . . . . . . . . . . . . . . . . . .
State of residence: Yourself__________________________ Spouse/RDP_________________________
Dates of California residency: Yourself from _____________ to ____________ Spouse/RDP from_____________ to ____________
State or country of domicile: Yourself________________________ Spouse/RDP_______________________
6 If someone can claim you (or your spouse/RDP) as a dependent, check the box here (see page 9) . . . . . . . . . . . . .
6
 For line 7, line 8, 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 or 4 above, enter 1 in the box . If you checked box 2 or 5, enter 2 in the box .
If you checked the box on line 6, see page 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
X $106 =
$ _________________
8 Blind: If you (or your spouse/RDP) are visually impaired, enter 1; if both are visually impaired, enter 2 . . 8
X $106 =
$ _________________
10 Dependents: Do not include yourself or your spouse/RDP.
Dependent’s
First name
Last name
relationship to you
Total dependent exemptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
X $326 =
$ _________________
11 Exemption amount: Add line 7 through line 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
$ _________________
00
12 Total California wages from your Form(s) W-2, box 16 . . . . . . . . . . . . . . . . . . . . . . .
12
13 Enter federal adjusted gross income from Form 1040, line 37; Form 1040A, line 21;
Form 1040EZ, line 4; Form 1040NR, line 36; or Form 1040NR-EZ, line 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
00
If the amount on line 13 is more than $100,000, stop here and use Long Form 540NR.
00
14 Unemployment compensation and military pay adjustment (see page 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
00
17 Adjusted gross income from all sources . Subtract line 14 from line 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17
18 Standard deduction for your filing status . If you checked the box on line 6, see page 10 .
• Single . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $3,906
00
• Married/RDP filing jointly, Head of household, or Qualifying widow(er) . . . . . . . . . . . . . . $7,812 . . . . . . . . . . . . . . .
18
19 Subtract line 18 from line 17 . This is your total taxable income . If less than zero, enter -0- . . . . . . . . . . . . . . . . . . .
19
00
3141133

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