If the nonresident individual s CA total taxable income from all sources is more than $1 million then enter "Y" for yes or "N" for no
Mental Health Services Tax See General Information for more information
See Schedule 1067A Instructions Part I for more information
"Y" or
(a)SSN or ITIN(FEINS not allowed
(c) + (d)
(c) col
(e) x 1%
(e) x 12 3%
(f) +
(g) + col
(g)Credit(h)Enter "Y" or "N"
(h) then
(h) then multiply
(i)Mental Health Services Tax
(or CA
(Part I plus Part 2)
(Use additional sheet(s) if necessary)
(Use additional sheets if necessary )
1067 Section H for more information
1067A
2 Total of Part II
3 Grand Total
7161143
7162143
allowed"N"
Amount of deferred compensation deduction
Attach this schedule to your California group Form 540NR
CA corporation or CA Secretary of State file no
CALIFORNIA SCHEDULE
col (e) by 1%
column
Column (a) and (b)
Column (c)
Column (d)
Column (g)
Column (h)
Column (i)
Corporation nameFEINDBACA corporation or CA Secretary of State file numberPart II
credits
Deferredcompensation(e)CA source income less deferred compensation col
Director s
Director s Compensation from California Sources(f)
Director s NameCA Wage
Director s SSN or ITIN
Electing Nonresident Directors Included in the Group Nonresident Return
Electing Nonresident Individuals (Shareholders/Partners/Members) Included in the Group Nonresident Return
Enter
Enter the individual s distributive share of California source income from the business entity s taxable year ending in 2014
First name MI Last name(c)
For Privacy Notice get FTB 1131 ENG/SP
Form 1099
Form W 2
Health
If the nonresident director s CA total taxable income from
If the nonresident individual has a spouse/RDP include the spouse s/RDP s information in both columns
If Yes
in column
incomeIncomeForm W 2
Mental
multiply
Net tax
Nonresident Group Return Schedule
Note:
Note: Column (h)
Part I
S Corporation/Partnership/Limited Liability Company name
SCH W 2)
Schedule 1067A 2014 Side 2
See FTB Pub
see instructions)
Services
Side 1 Schedule 1067A 2014
sources is more than $1 million then enter "Y" for yes or "N" for no
Tax credit allowable
TAXABLE YEAR
Total CA source income(d)
Total of Part I
Total tax
Total tax col
TotalReported
Withholding
x 12 3%
