540 Form Fillable California Resident Income Tax Return
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

7 Personal: If you checked box 1 3 or 4 above enter 1 in the box If you checked 8 Blind: If you (or your spouse/RDP) are visually impaired enter 1; 9 Senior: If you (or your spouse/RDP) are 65 or older enter 1; Code Amount First name Last name Dependent's relationship to you 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 FTB 3800 FTB 3803 31 If the box on line 6 is checked STOP See instructions 18 If you filed your 2012 tax return under a different last name write the last name only from the 2012 tax return If your California filing status is different from your federal filing status check the box here m larger of: Your California standard deduction shown below for your filing status: Mail to: FRANCHISE TAX BOARD Married/RDP filing jointly Head of household or Qualifying widow(er) $7 812 Pay online Go to ftb ca gov for more information Routing number Checking Account number 116 Direct deposit amount Routing number Checking Account number 117 Direct deposit amount Savings Single or Married/RDP filing separately $3 906 Taxpayer Spouse/RDP Total dependent exemptions 10 m X $326 = $ Your DOB (mm/dd/yyyy) Spouse's/RDP's DOB (mm/dd/yyyy) (See instructions) 1 m Single 4 m Head of household (with qualifying person) See instructions 10 Dependents: Do not include yourself or your spouse/RDP 11 Exemption amount: Add line 7 through line 10 Transfer this amount to line 32 11 $ 110 Add code 400 through code 426 This is your total contribution 110 111 AMOUNT YOU OWE Add line 94 line 95 and line 110 See instructions Do not send cash 112 Interest late return penalties and late payment penalties 112 00 113 Underpayment of estimated tax Check the box: FTB 5805 attached FTB 5805F attached 113 114 Total amount due See instructions Enclose but do not staple any payment 114 115 REFUND OR NO AMOUNT DUE Subtract line 95 and line 110 from line 93 See instructions 12 State wages from your Form(s) W 2 box 16 12 13 Enter federal adjusted gross income from Form 1040 line 37; 1040A line 21; or 1040EZ line 4 13 14 California adjustments subtractions Enter the amount from Schedule CA (540) line 37 column B 14 15 Subtract line 14 from line 13 If less than zero enter the result in parentheses See instructions 15 16 California adjustments additions Enter the amount from Schedule CA (540) line 37 column C 16 17 California adjusted gross income Combine line 15 and line 16 17 18 Enter the Your California itemized deductions from Schedule CA (540) line 44; OR 19 Subtract line 18 from line 17 This is your taxable income If less than zero enter 0 19 2 m Married/RDP filing jointly See inst 5 m Qualifying widow(er) with dependent child Enter year spouse/RDP died 3 m Married/RDP filing separately Enter spouse s/RDP s SSN or ITIN above and full name here 31 Tax Check the box if from: Tax Table Tax Rate Schedule 3101133 3102133 3103133 3104133 3105133 32 Exemption credits Enter the amount from line 11 If your federal AGI is more than $172 615 33 Subtract line 32 from line 31 If less than zero enter 0 33 34 Tax See instructions Check the box if from: Schedule G 1 FTB 5870A 34 35 Add line 33 and line 34 35 40 Nonrefundable Child and Dependent Care Expenses Credit See instructions 40 41 New jobs credit amount generated See instructions 41 42 New jobs credit amount claimed See instructions 42 43 Enter credit name code and amount 43 44 Enter credit name code and amount 44 45 To claim more than two credits see instructions Attach Schedule P (540) 45 46 Nonrefundable renter s credit See instructions 46 47 Add line 40 and line 42 through line 46 These are your total credits 47 48 Subtract line 47 from line 35 If less than zero enter 0 48 540 C1 Side 1 6 If someone can claim you (or your spouse/RDP) as a dependent check the box here See inst 6 m 61 Alternative minimum tax Attach Schedule P (540) 61 62 Mental Health Services Tax See instructions 62 63 Other taxes and credit recapture See instructions 63 64 Add line 48 line 61 line 62 and line 63 This is your total tax 64 71 California income tax withheld See instructions 71 72 2013 CA estimated tax and other payments See instructions 72 73 Real estate and other withholding See instructions 73 74 Excess SDI (or VPDI) withheld See instructions 74 75 Add line 71 line 72 line 73 and line 74 These are your total payments See instructions 75 91 Overpaid tax If line 75 is more than line 64 subtract line 64 from line 75 91 92 Amount of line 91 you want applied to your 2014 estimated tax 92 93 Overpaid tax available this year Subtract line 92 from line 91 93 94 Tax due If line 75 is less than line 64 subtract line 75 from line 64 94 95 Use Tax This is not a total line See instructions 95 Additional information (See instructions) PBA Code All or the following amount of my refund (line 115) is authorized for direct deposit into the account shown below: Alzheimer s Disease/Related Disorders Fund 401 American Red Cross California Chapters Fund 426 Amount Birth box 2 or 5 enter 2 in the box If you checked the box on line 6 see instructions 7 m X $106 = $ California Breast Cancer Research Fund 405 California Cancer Research Fund 413 California Firefighters Memorial Fund 406 California Fund for Senior Citizens 402 California Peace Officer Memorial Foundation Fund 408 California Resident Income Tax Return 2013 California Sea Otter Fund 410 California Seniors Special Fund See instructions 400 California YMCA Youth and Government Fund 420 California Youth Leadership Fund 421 Child Victims of Human Trafficking Fund 419 City (If you have a foreign address see instructions) State ZIP Code Contributions Date of Do you want to allow another person to discuss this tax return with us? See instructions m Yes m No Emergency Food for Families Fund 407 Exemptions Filing Fill in the information to authorize direct deposit of your refund into one or two accounts Do not attach a voided check or a deposit slip See instructions Firm s address FEIN Firm s name (or yours if self employed) PTIN Fiscal year filers only: Enter month of year end: month year 2014 For Privacy Notice get FTB 1131 ENG/SP Foreign Country Name Foreign Province/State/County Foreign Postal Code Form 540 C1 2013 Side 3 Have you verified the routing and account numbers? Use whole dollars only if both are 65 or older enter 2 9 m X $106 = $ if both are visually impaired enter 2 8 m X $106 = $ If joint tax return spouse's/RDP's first name Initial Last name Spouse's/RDP's SSN or ITIN IMPORTANT: See the instructions to find out if you should attach a copy of your complete federal tax return Interest and It is unlawful Joint tax return? Keep Arts in Schools Fund 425 knowledge and belief it is true correct and complete Mail to: FRANCHISE TAX BOARD Municipal Shelter Spay Neuter Fund 412 Other Taxes Overpaid Tax/ Paid preparer s signature (declaration of preparer is based on all information of which preparer has any knowledge) Payments Penalties PO BOX 942840 PO BOX 942867 Print Third Party Designee s Name Telephone Number Prior Protect Our Coast and Oceans Fund 424 Rare and Endangered Species Preservation Program 403 Refund and Direct Deposit SACRAMENTO CA 94240 0001 115 SACRAMENTO CA 94267 0001 111 School Supplies for Homeless Children Fund 422 see instructions 32 Side 2 Form 540 C1 2013 signature Special Credits spouse s/RDP s State Children s Trust Fund for the Prevention of Child Abuse 404 State Parks Protection Fund/Parks Pass Purchase 423 Status Street address (Number and street or PO Box) Apt no/Ste no PMB/Private Mailbox Tax Due Taxable Income The remaining amount of my refund (line 115) is authorized for direct deposit into the account shown below: This space reserved for 2D barcode to forge a Under penalties of perjury I declare that I have examined this tax return including accompanying schedules and statements and to the best of my You Owe Your email address (optional) Enter only one email address Daytime phone number (optional) Your first name Initial Last name Your SSN or ITIN Your name: Your SSN or ITIN: Your name: Your SSN or ITIN: Your signature Date Spouse s/RDP s signature (if a joint tax return both must sign)