540-X Form Fillable Amended Individual Income Tax Return
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

1 a State wages See instructions 1a 2 CA adjustments Get specific instructions on Form 540A or Sch CA (540) 3 Total California adjustments Combine line 2a through line 2e See instructions 3 4 California adjusted gross income Combine line 1b and line 3 See instructions 4 5 California itemized deductions or California standard deduction See instructions 5 6 Taxable income Subtract line 5 from line 4 If less than zero enter 0 6 7 a Tax method used for line 7b column C See instructions 7a TT FTB 3800 FTB 3803 8 Exemption credits See instructions 8 9 Subtract line 8 from line 7b If less than zero enter 0 9 a California nontaxable interest income 2a Amended tax return Amended tax return Single Married/RDP filing jointly Married/RDP filing separately Head of household Qualifying widow(er) Amount previously reported and corrected amount b Federal adjusted gross income See instructions 1b b State income tax refund 2b b Tax See instructions 7b c Unemployment compensation 2c d Social Security benefits 2d e Other (list) 2e Federal tax return and schedules if you made changes If Yes attach a copy of the final federal determination and all supporting schedules and data Item being changed Original tax return Single Married/RDP filing jointly Married/RDP filing separately Head of household Qualifying widow(er) Reason the change was needed Revised California tax return including all forms and schedules Supporting documents such as corrected W 2s 1099s K 1s etc 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 1 Exemption amount 1 10 Tax from Schedule G 1 and form FTB 5870A See instructions 10 11 Add line 9 and line 10 11 12 Special Credits and Nonrefundable Credits See instructions 13 Subtract line 12 from line 11 13 14 Other taxes (alternative minimum tax credit recapture etc ) See instructions 14 15 Mental Health Services Tax See instructions 15 16 Total tax Add line 13 line 14 and line 15 17 California income tax withheld See instructions 17 18 Real estate and other withholding (Form(s) 592 B or 593) See instructions 18 19 Excess California SDI (or VPDI) withheld See instructions 19 2 Are you filing this Form 540X to report a final federal determination? Yes No 2 Federal adjusted gross income 2 20 Estimated tax payments and other payments See instructions 20 21 Refundable Credits See instructions 21 22 23 24 $ 25 Tax paid with original tax return plus additional tax paid after it was filed Do not include penalties and interest 2526 Total payments Add lines 17 18 19 20 21 and 25 of column C 2627 Overpaid tax if any as shown on original tax return or as previously adjusted by the FTB See instructions 2728 Subtract line 27 from line 26 If line 27 is more than line 26 See instructions 2829 Use tax payments as shown on original tax return See instructions 2930 Voluntary contributions as shown on original tax return See instructions 3031 Subtract line 29 and line 30 from line 28 3132 AMOUNT YOU OWE If line 16 column C is more than line 31 enter the difference 3 Adjusted gross income from all sources 3 3 Have you been advised that your original California tax return has been is being or will be audited? Yes No 3151143 3152143 3153143 4 Did you file an amended tax return with the Internal Revenue Service on a similar basis? See General Information E Yes No 4 Itemized deductions or standard deduction 4 5 California adjusted gross income 5 5 Explanation and Attachments Explain your changes below If needed attach a separate sheet that includes your name and SSN or ITIN 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) 910 Other taxes and credit recapture 10 a Have you been advised that your original federal tax return has been is being or will be audited? Yes No Additional information (See instructions) adjusted by the FTB All filers: Explain changes on Side 3 and attach your supporting documents Amended Individual Income Tax Return and see instructions 32 0033 Penalties/Interest See instructions: Penalties 33a Interest 33b 33c34 REFUND If line 16 column C is less than line 31 enter the difference See instructions 34 00Part I Nonresidents or Part Year Residents OnlyAttach and enter the amounts from your revised Short or Long Form 540NR and Schedule CA (540NR) Your amended tax return cannot be processed without Apt no /Ste no As originally reported/ Attach: b Filing status claimed on: 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 CALIFORNIA FORM City (If you have a foreign address see page 2) Correct amount d If claiming head of household enter name and relationship of qualifying person on: Original tax return 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 Explain in detail each change made Include: Explain on Side 3 Firm s address FEIN Firm s name (or yours if self employed) PTIN Fiscal year filers only: Enter month of year end and year (mm/yyyy) BE SURE TO COMPLETE AND SIGN SIDE 3 For Privacy Notice get FTB 1131 ENG/SP Foreign Country Name Foreign Province/State/County Foreign Postal Code Form 540X Form 540X C1 2014 Side 1 If amending Form 540NR see General Information D If amending Form 540NR See instructions 16 If amending Forms 540 2EZ 540 or 540A see the instructions for lines 1 through 6 If joint tax return spouse s/RDP s first name If you are due a refund have no amount due or paid electronically If you owe mail your return and check or money order to: FRANCHISE TAX BOARD PO BOX 942867 SACRAMENTO CA 94267 0001 Initial It is unlawful Last name mail your tax return to: FRANCHISE TAX BOARD PO BOX 942840 SACRAMENTO CA 94240 0001 Net change Paid preparer s signature (declaration of preparer is based on all information of which preparer has any knowledge) Part II Explanation of Changes Part ll line 5 PBA Code PMB/Private Mailbox schedules and statements and to the best of my knowledge and belief this amended tax return is true correct and complete See instructions separate tax returns to a joint tax return enter names and addresses from original tax returns Side 2 Form 540X C1 2014 signature spouse s/RDP s Spouse s/RDP s SSN or ITIN State Street address (Number and street) or PO Box Suffix TAXABLE YEAR this information to forge a Under penalties of perjury I declare that I have filed an original tax return and I have examined this amended tax return including accompanying Where to File Your email address (optional) Enter only one email address Daytime phone number (optional) Your first name Your name: Your SSN or ITIN: Your signature Date Spouse s/RDP s signature (if a joint tax return both must sign) Your SSN or ITIN ZIP Code