Fillable Printable 2012 Form 540X - Amended Individual Income Tax Return

2012 Form 540X - Amended Individual Income Tax Return

Form 540X C1 2012 Side 1

For Privacy Notice, get form FTB 1131.

Amended Individual Income Tax Return

CALIFORNIA FORM

540X

3151123

T AXABLE YEAR

Fiscal year ﬁlers only: Enter month of year end _______ year _______. BE SURE TO COMPLETE AND SIGN SIDE 2

a Have you been advised that your original federal tax return has been, is being, or will be audited?................ m Yes m No

b Filing status claimed:

On original return  m Single m Married/RDP ﬁling jointly m Married/RDP ﬁling separately m Head of household m Qualifying widow(er)

On this return  mSingle m Married/RDP ﬁling jointly m Married/RDP ﬁling separately m Head of household m Qualifying widow(er)

c If for the year you are amending, you (or your spouse/RDP) can be claimed as a dependent on someone else’s tax return, check this box.......... m

d If claiming head of household, enter name and relationship of qualifying person on: Original return ___________________________________

Amended return __________________________________

Correct amount

Net change

Explain on Side 2,

Part ll, line 5

As originally reported/

adjusted by the FTB

See instructions

If amending Form 540NR, see General Information D.

If amending Forms 540 2EZ, 540, or 540A, see the instructions for lines 1 through 6.

All ﬁlers: Explain changes on Side 2 and attach your supporting documents.

1 a State wages. See instructions .......................................1a  1a

b Federal adjusted gross income. See instructions ........................1b 1b

2 CA adjustments. Get speciﬁc instructions on Form 540A or Sch. CA (540).

a California nontaxable interest income .................................2a

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b State income tax refund ...........................................2b 2b

c Unemployment compensation ......................................2c 2c

d Social Security beneﬁts............................................2d 2d

e Other (list)__________________________________________________....2e 2e

3 Total California adjustments. Combine line 2a through line 2e. See instructions . . . . 3  3

4 California adjusted gross income. Combine line 1b and line 3. See instructions ....4  4

5 California itemized deductions or California standard deduction. See instructions ..5  5

6 Taxable income. Subtract line 5 from line 4. If less than zero, enter -0- ....... 6 6

7 a Tax method used for line 7b, column C. See instructions ............... 7a m TT m FTB 3800 m FTB 3803

b Tax. See instructions ..............................................7b  7b

8 Exemption credits. See instructions ......................................8  8

9 Subtract line 8 from line 7b. If less than zero, enter -0- .......................9 9

10 Tax from Schedule G-1 and form FTB 5870A. See instructions ................10  10

11 Add line 9 and line 10................................................11 11

12 Special Credits and Nonrefundable Credits. See instructions..................12  12

13 Subtract line 12 from line 11 ..........................................13 13

14 Other taxes (alternative minimum tax, credit recapture, etc.). See instructions ....14  14

15 Mental Health Services Tax, see instructions ..............................15  15

16 Total tax. Add line 13, line 14, and line 15.

If amending Form 540NR, see instructions ...............................16  16

17 California income tax withheld. See instructions ...........................17  17

18 Real estate and other withholding (Form(s) 592-B or 593). See instructions .....18  18

19 Excess California SDI (or VPDI) withheld. See instructions ...................19  19

20 Estimated tax payments and other payments. See instructions ................20  20

Refundable Credits. See instructions

. ....................................21  21

 22 __________________________________  23 _________________________________ 24 $ ____________________

25 Tax paid with original tax return plus additional tax paid after it was ﬁled ............................................. 25

26 Total payments. Add lines 17, 18, 19, 20, 21, and 25 of column C................................................... 26

Spouse’s/RDP’s SSN or ITIN

Your SSN or ITIN

Your ﬁrst name

Last name

Initial

If joint return, spouse’s/RDP’s ﬁrst name

Last name

Initial

Address (number and street, PO Box, or PMB no.)

Apt. no./Ste. no.

City State ZIP Code

- -

- - - -

Side 2 Form 540X C1 2012 3152123

Your name: Your SSN or ITIN:

26a Enter the amount from Side 1, line 26 .........................................................................26a

27 Overpaid tax, if any, as shown on original tax return or as previously adjusted by the FTB. See instructions .................. 27

28 Subtract line 27 from line 26a. If line 27 is more than line 26a, see instructions ..........................................28

29 Use tax payments as shown on original tax return. See instructions ................................................. 29

30 Voluntary contributions as shown on original tax return. See instructions ............................................ 30

31 Subtract line 29 and line 30 from line 28 ........................................................................31

32 AMOUNT YOU OWE. If line 16, column C is more than line 31, enter the difference

and see instructions.................................................................... 32

33 Penalties/Interest. See instructions: Penalties 33a______________________ Interest 33b______________________________  33c

34 REFUND. If line 16, column C is less than line 31, enter the difference. See instructions ............... 34

Part I Nonresidents or Part-Year Residents Only

Attach and enter the amounts from your revised Short or Long Form 540NR and Schedule CA (540NR). Your amended tax return cannot be processed without

this information.

1 Exemption amount ....................................................................................... 1

2 Federal adjusted gross income ............................................................................. 2

3 Adjusted gross income from all sources ...................................................................... 3

4 Itemized deductions or standard deduction .................................................................... 4

5 California adjusted gross income ............................................................................ 5

6 Tax from Schedule G-1 and form FTB 5870A ................................................................... 6

7 Special credits and nonrefundable renter’s credit................................................................ 7

8 Alternative minimum tax .................................................................................. 8

9 Mental Health Services Tax (taxable years 2005 and after) ........................................................ 9

10 Other taxes and credit recapture ............................................................................10

Part II Explanation of Changes

1 Enter name(s) and address as shown on original return below (if same as shown on this tax return, write “Same”). If changing from

separate tax returns to a joint tax return, enter names and addresses from original tax returns._________________________________________________

_______________________________________________________________________________________________________________________

2 Are you ﬁling this Form 540X to report a ﬁnal federal determination? ......................................................... m Yes m No

If “Yes,” attach a copy of the ﬁnal federal determination and all supporting schedules and data.

3 Have you been advised that your original California tax return has been, is being, or will be audited? ................................ m Yes m No

4 Did you ﬁle an amended tax return with the Internal Revenue Service on a similar basis? See General Information E ...................

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m Yes m No

5 Explanation and Attachments. Explain your changes below. If needed, attach a separate sheet that includes your name and SSN or ITIN.

Explain in detail each change made. Include:

• Item being changed.

• Amount previously reported and corrected amount.

• Reason the change was needed.

Attach:

• Revised California tax return including all forms and schedules.

• Federal tax return and schedules if you made changes.

• Supporting documents, such as corrected W-2s, 1099s, K-1s, etc.

__________________________________________________________________________________________________________________________________

Sign

Here

t is unlawful

to forge a

spouse’s/RDP’s

signature.

Where to File

Form 540X

Under penalties of perjury, I declare that I have ﬁled an original tax return and that I have examined this amended tax return including accompanying schedules and

statements and to the best of my knowledge and belief, this amended tax return is true, correct, and complete.

Paid preparer’s signature (declaration of preparer is based on all information of which preparer has any knowledge)

Firm’s name (or yours if self-employed) Firm’s address



PTIN

Your signature Spouse’s/RDP’s signature (if ﬁling jointly, both must sign) Daytime phone number (optional)

X X Date

(

)



FEIN

Do not ﬁle a duplicate amended tax return unless one is requested. This may cause a delay in processing your amended tax return and any claim for refund.

If you are due a refund, have no amount due, or paid electronically,

mail your tax return to: FRANCHISE TAX BOARD, PO BOX 942840, SACRAMENTO CA 94240-0001

If you owe, mail your return and check or money order to: FRANCHISE TAX BOARD, PO BOX 942867, SACRAMENTO CA 94267-0001

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