This form can only be used if you are resident of the State of California for the whole year and your source of Income is from California and you are eligible to pay the Tax. The California 540A Income Tax form is meant for the State of California only.
Text Version of this Form
For Privacy Notice, get form FTB 1131.
540A C1 Side 1
California Resident Income Tax Return 2012
Your first name Initial Last name Your SSN or ITIN
If joint tax return, spouse’s/RDP’s first name Initial Last name Spouse’s/RDP’s SSN or ITIN
Address (number and street, PO Box, or PMB no.) Apt. no/Ste. no.
City (If you have a foreign address, see page 7.) State ZIP Code
If you filed your 2011 tax return under a different last name, write the last name only from the 2011 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 7) . . 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, enter 2 in the box.
If you checked the box on line 6, see page 7 . 7 .. X $104 = $________________
8 Blind: If you (or your spouse/RDP) are visually impaired, enter 1; if both are visually impaired, enter 2 8 .. X $104 = $________________
9 Senior: If you (or your spouse/RDP) are 65 or older, enter 1; if both are 65 or older, enter 2 . 9 .. X $104 = ¦$________________
10 Dependents: Do not include yourself or your spouse/RDP.
relationship to you
Total dependent exemptions . 10 .. X $321 = ¦$________________
11 Exemption amount: Add line 7 through line 10. Transfer this amount to line 32 . 11 $________________
Taxable Income and
California Income Adjustments
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 Income Adjustments. See pages 8 and 9 for line 14a through line 14f.
a State income tax refund . ¦14a 00
b Unemployment compensation . ¦14b 00
c U.S. social security or railroad retirement . ¦14c 00
d California non-taxable interest or dividend income ¦14d 00
e California IRA distributions ¦14e 00
f Non-taxable pensions and annuities . ¦14f 00
g Total California income adjustments. Add line 14a through line 14f . 14g
17 Subtract line 14g from line 13. This is your California adjusted gross income . 17
18 Enter the larger of your California itemized deductions or standard deduction for your filing status
• Single or Married/RDP filing separately . $3,841
• Married/RDP filing jointly, Head of household, or Qualifying widow(er) $7,682
If the box on line 6 is checked, STOP (see page 9) . . 18
19 Subtract line 18 from line 17. This is your taxable income. If less than zero, enter -0- ¦ 19
. Your DOB (mm/dd/yyyy) ______/______/___________ . Spouse’s/RDP’s DOB (mm/dd/yyyy) ______/______/___________