U.S. Individual Income Tax Return: Filing Status
U.S. Individual Income Tax Return: Filing Status
OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.
Filing Status ✔ Single Married filing jointly Married filing separately (MFS) Head of household (HOH) Qualifying widow(er) (QW)
Check only If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QW box, enter the child’s name if the qualifying
one box.
person is a child but not your dependent ▶
Your first name and middle initial Last name Your social security number
DAVID DAUTEL 5 6 0 5 5 0 3 7 8
If joint return, spouse’s first name and middle initial Last name Spouse’s social security number
Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Presidential Election Campaign
2025 RAPHAEL CT Check here if you, or your
spouse if filing jointly, want $3
City, town, or post office. If you have a foreign address, also complete spaces below. State ZIP code
to go to this fund. Checking a
WALNUT CREEK CA 94598 box below will not change
Foreign country name Foreign province/state/county Foreign postal code your tax or refund.
You Spouse
At any time during 2020, did you receive, sell, send, exchange, or otherwise acquire any financial interest in any virtual currency? Yes ✔ No
Age/Blindness You: Were born before January 2, 1956 Are blind Spouse: Was born before January 2, 1956 Is blind
Dependents (see instructions): (2) Social security (3) Relationship (4) ✔ if qualifies for (see instructions):
(1) First name Last name number to you Child tax credit Credit for other dependents
If more
than four
dependents,
see instructions
and check
here ▶
1 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . . . 1 2953
Attach 2a Tax-exempt interest . . . 2a 2b
b Taxable interest . . . . .
Sch. B if
3a Qualified dividends . . . 3a b Ordinary dividends . . . . . 3b
required.
4a IRA distributions . . . . 4a b Taxable amount . . . . . . 4b
5a Pensions and annuities . . 5a b Taxable amount . . . . . . 5b
Standard 6a Social security benefits . . 6a b Taxable amount . . . . . . 6b
Deduction for—
7 Capital gain or (loss). Attach Schedule D if required. If not required, check here . . . . ▶ 7
• Single or
Married filing 8 Other income from Schedule 1, line 9 . . . . . . . . . . . . . . . . . . . 8
separately,
$12,400 9 Add lines 1, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income . . . . . . . . . ▶ 9 2953
• Married filing 10 Adjustments to income:
jointly or
Qualifying a From Schedule 1, line 22 . . . . . . . . . . . . . . 10a
widow(er),
$24,800
b Charitable contributions if you take the standard deduction. See instructions 10b
• Head of c Add lines 10a and 10b. These are your total adjustments to income . . . . . . . . ▶ 10c
household,
$18,650 11 Subtract line 10c from line 9. This is your adjusted gross income . . . . . . . . . ▶ 11 2953
• If you checked 12 Standard deduction or itemized deductions (from Schedule A) . . . . . . . . . . 12 12400
any box under
Standard 13 Qualified business income deduction. Attach Form 8995 or Form 8995-A . . . . . . . . 13
Deduction,
see instructions.
14 Add lines 12 and 13 . . . . . . . . . . . . . . . . . . . . . . . . 14 12400
15 Taxable income. Subtract line 14 from line 11. If zero or less, enter -0- . . . . . . . . . 15
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 11320B Form 1040 (2020)
Form 1040 (2020) Page 2
16 Tax (see instructions). Check if any from Form(s): 1 8814 2 4972 3 . . 16
17 Amount from Schedule 2, line 3 . . . . . . . . . . . . . . . . . . . . 17
18 Add lines 16 and 17 . . . . . . . . . . . . . . . . . . . . . . . . 18
19 Child tax credit or credit for other dependents . . . . . . . . . . . . . . . . 19
20 Amount from Schedule 3, line 7 . . . . . . . . . . . . . . . . . . . . 20
21 Add lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . 21
22 Subtract line 21 from line 18. If zero or less, enter -0- . . . . . . . . . . . . . . 22
23 Other taxes, including self-employment tax, from Schedule 2, line 10 . . . . . . . . . 23
24 Add lines 22 and 23. This is your total tax . . . . . . . . . . . . . . . . ▶ 24
25 Federal income tax withheld from:
a Form(s) W-2 . . . . . . . . . . . . . . . . . . 25a 126
b Form(s) 1099 . . . . . . . . . . . . . . . . . . 25b
c Other forms (see instructions) . . . . . . . . . . . . . 25c
d Add lines 25a through 25c . . . . . . . . . . . . . . . . . . . . . . 25d 126
• If you have a 26 2020 estimated tax payments and amount applied from 2019 return . . . . . . . . . . 26
qualifying child, 27 Earned income credit (EIC) . . . . . . . . . . . . . . 27 228
attach Sch. EIC.
• If you have 28 Additional child tax credit. Attach Schedule 8812 . . . . . . . 28
nontaxable 29 American opportunity credit from Form 8863, line 8 . . . . . . . 29
combat pay,
see instructions. 30 Recovery rebate credit. See instructions . . . . . . . . . . 30
31 Amount from Schedule 3, line 13 . . . . . . . . . . . . 31
32 Add lines 27 through 31. These are your total other payments and refundable credits . . . ▶ 32 228
33 Add lines 25d, 26, and 32. These are your total payments . . . . . . . . . . . ▶ 33 354
34 If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid . . 34 354
Refund
35a Amount of line 34 you want refunded to you. If Form 8888 is attached, check here . . . ▶ 35a 354
Direct deposit? ▶b Routing number X X X X X X X X X ▶ c Type: Checking Savings
See instructions. ▶
d Account number X X X X X X X X X X X X X X X X X
36 Amount of line 34 you want applied to your 2021 estimated tax . . ▶ 36
Amount 37 Subtract line 33 from line 24. This is the amount you owe now . . . . . . . . . . ▶ 37
You Owe Note: Schedule H and Schedule SE filers, line 37 may not represent all of the taxes you owe for
For details on 2020. See Schedule 3, line 12e, and its instructions for details.
how to pay, see
instructions. 38 Estimated tax penalty (see instructions) . . . . . . . . . ▶ 38
Third Party Do you want to allow another person to discuss this return with the IRS? See
Designee instructions . . . . . . . . . . . . . . . . . . . . ▶ Yes. Complete below. No
Designee’s Phone Personal identification
name ▶ no. ▶ number (PIN) ▶
Sign Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and
belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Here Your signature Date Your occupation If the IRS sent you an Identity
Protection PIN, enter it here
▲
Go to www.irs.gov/Form1040 for instructions and the latest information. Form 1040 (2020)
TAXABLE YEAR FORM
560-55-0378
DAVID DAUTEL
2025 RAPHAEL CT
WALNUT CREEK CA 94598
10-08-1963 DAUTEL
CONTRA COSTA
Principal Residence
If your address above is the same as your principal/physical residence address at the time of filing, check this box. . . X
If not, enter below your principal/physical residence address at the time of filing.
Street address (number and street) (If foreign address, see instructions.) Apt. no/ste. no.
If your California filing status is different from your federal filing status, check the box here. . . . . . . . . . . . . .
2 Married/RDP filing jointly. See inst. 5 Qualifying widow(er). Enter year spouse/RDP died.
See instructions.
3 Married/RDP filing separately. Enter spouse’s/RDP’s SSN or ITIN above and full name here.
6 If someone can claim you (or your spouse/RDP) as a dependent, check the box here. See inst. . . . . . . . • 6
▶ For line 7, line 8, line 9, and line 10: Multiply the number 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
Exemptions
box 2 or 5, enter 2 in the box. If you checked the box on line 6, see instructions. 7 1 X $124 = $ 124
8 Blind: If you (or your spouse/RDP) are visually impaired, enter 1;
if both are visually impaired, enter 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 X $124 = $
9 Senior: If you (or your spouse/RDP) are 65 or older, enter 1;
if both are 65 or older, enter 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . •9 X $124 = $
Last Name
Exemptions
SSN. See
instructions. • • •
Dependent’s
relationship
to you
11 Exemption amount: Add line 7 through line 10. Transfer this amount to line 32 . . . . . . . . . . . . . 11 $ 124
• 2953 . 00
{ {
17 California adjusted gross income. Combine line 15 and line 16 . . . . . . . . . . . . . . . . . . . . . . . 17
18 Enter the Your California itemized deductions from Schedule CA (540), Part II, line 30; OR
larger of Your California standard deduction shown below for your filing status:
• Single or Married/RDP filing separately. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $4,601
• Married/RDP filing jointly, Head of household, or Qualifying widow(er). . . . . $9,202
If Married/RDP filing separately or the box on line 6 is checked, STOP. See instructions • 18
4601 . 00
19 Subtract line 18 from line 17. This is your taxable income.
If less than zero, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 . 00
33 Subtract line 32 from line 31. If less than zero, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 . 00
34 Tax. See instructions. Check the box if from: • Schedule G-1 • FTB 5870A . . • 34 . 00
• . 00
Special Credits
45 To claim more than two credits. See instructions. Attach Schedule P (540) . . . . . . . . . . . . . • 45 . 00
Special Credits
47 Add line 40 through line 46. These are your total credits . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 . 00
48 Subtract line 47 from line 35. If less than zero, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 . 00
65 Add line 48, line 61, line 62, line 63, and line 64. This is your total tax . . . . . . . . . . . . . . . . . • 65 . 00
•
Do not paper file - not approved
75 Earned Income Tax Credit (EITC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 193 . 00
• . 00
Use Tax
If line 91 is zero, check if: No use tax is owed. You paid your use tax obligation directly to CDTFA.
• . 00
Penalty
93 Payments balance. If line 78 is more than line 91, subtract line 91 from line 78 . . . . . . . . . . 93
218 . 00
94 Use Tax balance. If line 91 is more than line 78, subtract line 78 from line 91 . . . . . . . . . . . 94 . 00
95 Payments after Individual Shared Responsibility Penalty. If line 93 is more than line 92,
subtract line 92 from line 93. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
218 . 00
96 Individual Shared Responsibility Penalty Balance. If line 92 is more than line 93, then
subtract line 93 from line 92. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96 . 00
97 Overpaid tax. If line 95 is more than line 65, subtract line 65 from line 95 . . . . . . . . . . . . . . 97 218 . 00
100 Tax due. If line 95 is less than line 65, subtract line 95 from line 65 . . . . . . . . . . . . . . . . . . . 100 . 00
Code Amount
Alzheimer’s Disease and Related Dementia Voluntary Tax Contribution Fund . . . . . . . . . . . . • 401 . 00
Rare and Endangered Species Preservation Voluntary Tax Contribution Program . . . . . . . . . • 403 . 00
California Peace Officer Memorial Foundation Voluntary Tax Contribution Fund . . . . . . . . . . • 408 . 00
Protect Our Coast and Oceans Voluntary Tax Contribution Fund . . . . . . . . . . . . . . . . . . . . . . • 424 . 00
Prevention of Animal Homelessness and Cruelty Voluntary Tax Contribution Fund . . . . . . . . • 431 . 00
•
110 Add code 400 through code 444. This is your total contribution . . . . . . . . . . . . . . . . . . . . . . 110 . 00
Do not paper file - not approved
111 AMOUNT YOU OWE. If you do not have an amount on line 99, add line 94, line 96, line 100, and line 110. See instructions. Do not send cash.
Amount
Mail to: FRANCHISE TAX BOARD, PO BOX 942867, SACRAMENTO CA 94267-0001 . . . . • 111 . 00
Pay Online – Go to ftb.ca.gov/pay for more information.
112 Interest, late return penalties, and late payment penalties . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 . 00
Interest and
Penalties
Check the box: • FTB 5805 attached • FTB 5805F attached . . . . . . . . . . . • 113 . 00
114 Total amount due. See instructions. Enclose, but do not staple, any payment . . . . . . . . . . . . 114 . 00
115 REFUND OR NO AMOUNT DUE. Subtract the sum of line 110, line 112 and line 113 from line 99. See instructions.
Mail to: FRANCHISE TAX BOARD, PO BOX 942840, SACRAMENTO CA 94240-0001. . . . . . • 115 218 . 00
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.
Refund and Direct Deposit
See instructions. Have you verified the routing and account numbers? Use whole dollars only.
All or the following amount of my refund (line 115) is authorized for direct deposit into the account shown below:
• Type
• Routing number Checking • Account number • 116 Direct deposit amount
. 00
Savings
The remaining amount of my refund (line 115) is authorized for direct deposit into the account shown below:
• Type
• Routing number Checking • Account number • 117 Direct deposit amount
. 00
Savings
IMPORTANT: See the instructions to find out if you should attach a copy of your complete federal tax return.
To learn about your privacy rights, how we may use your information, and the consequences for not providing the requested information, go to
ftb.ca.gov/forms and search for 1131. To request this notice by mail, call 800.852.5711.
Under penalties of perjury, I declare that I have examined this tax return, including accompanying schedules and statements, and to the best of my
knowledge and belief, it is true, correct, and complete.
Your signature Date Spouse’s/RDP’s signature (if a joint tax return, both must sign)
Your email address. Enter only one email address. Preferred phone number
Sign
Here Paid preparer’s signature (declaration of preparer is based on all information of which preparer has any knowledge)
1 Wages, salaries, tips, etc. See instructions before making an entry in column B or C . . . . 1 2953
2 Taxable interest. a . . . . . . . . . . . . . . . . . . . . . . . . . . 2b
3 Ordinary dividends. See instructions. a . . . . . . . . . 3b
4 IRA distributions. See instructions. a . . . . . . . . . 4b
5 Pensions and annuities. See instructions. a . . . . . . . . . 5b
6 Social security benefits. a . . . . . . . . . 6b
7 Capital gain or (loss). See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Section B – Additional Income from federal Schedule 1 (Form 1040)
1 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . . . . . . . . . . . 1
2a Alimony received. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a
3 Business income or (loss). See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Other gains or (losses) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
5 Rental real estate, royalties, partnerships, S corporations, trusts, etc . . . . . . . . . . . . . . . 5
6 Farm income or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
{
7 Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
8 Other income. a a
a California lottery winnings e NOL from FTB 3805Z, b b
b Disaster loss deduction from FTB 3805V 3807, or 3809 8 c c
c Federal NOL (federal Schedule 1 f Other (describe): d d
(Form 1040), line 8)
e e
d NOL deduction from FTB 3805V f f
g Student loan discharged due to
closure of a for-profit school g g
9 Total. Combine Section A, line 1 through line 7, and Section B, line 1 through line 8 in
column A. Add Section A, line 1 through line 7, and Section B, line 1 through line 8g in
column B and column C. Go to Section C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 2953
Section C – Adjustments to Income from federal Schedule 1 (Form 1040)
10 Educator expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
11 Certain business expenses of reservists, performing artists, and fee-basis
government officials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
12 Health savings account deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
13 Moving expenses. Attach federal Form 3903. See instructions . . . . . . . . . . . . . . . . . . . . 13
14 Deductible part of self-employment tax. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . 14
15 Self-employed SEP, SIMPLE, and qualified plans ������������������������������������������������������������ 15
16 Self-employed health insurance deduction. See instructions. . . . . . . . . . . . . . . . . . . . . . 16
17 Penalty on early withdrawal of savings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
18a Alimony paid. b Recipient’s: SSN – –
Last name 18a
19 IRA deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20 Student loan interest deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
21 Tuition and fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
22 Add line 10 through line 18a and line 19 through line 21 in columns A, B, and C.
See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
23 Total. Subtract line 22 from line 9 in columns A, B, and C. See instructions . . . . . . . . . . 23 2953
For Privacy Notice, get FTB 1131 ENG/SP. 214 7731204 Schedule CA (540) 2020 Side 1
Part II Adjustments to Federal Itemized Deductions A Federal Amounts
(from federal Schedule A
(Form 1040)
B Subtractions
See instructions C Additions
See instructions
Check the box if you did NOT itemize for federal but will itemize for California . . . . . . . . . .
Medical and Dental Expenses See instructions.
1 Medical and dental expenses . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Enter amount from federal Form 1040 or 1040-SR, line 11 2
3 Multiply line 2 by 7.5% (0.075) . . . . . . . . . . . . . . . . . . . . . . 3
4 Subtract line 3 from line 1. If line 3 is more than line 1, enter 0 . . . . . . . . . . . . . . . . . . . . 4
Taxes You Paid
5a State and local income tax or general sales taxes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5a
5b State and local real estate taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5b
5c State and local personal property taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5c
5d Add line 5a through line 5c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5d
5e Enter the smaller of line 5d or $10,000 ($5,000 if married filing separately) in column A . .
Enter the amount from line 5a, column B in line 5e, column B . . . . . . . . . . . . . . . . . . . . .
Enter the difference from line 5d and line 5e, column A in line 5e, column C . . . . . . . . . . 5e
6 Other taxes. List type . . . . . . . . . . . . . . . . . . . . . . . 6
7 Add line 5e and line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Interest You Paid
8a Home mortgage interest and points reported to you on federal Form 1098 . . . . . . . . . . 8a
8b Home mortgage interest not reported to you on federal Form 1098 . . . . . . . . . . . . . . . . 8b
8c Points not reported to you on federal Form 1098 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8c
8d Mortgage insurance premiums . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8d
8e Add line 8a through line 8d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8e
9 Investment interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
10 Add line 8e and line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Gifts to Charity
11 Gifts by cash or check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
12 Other than by cash or check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
13 Carryover from prior year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
14 Add line 11 through line 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Casualty and Theft Losses
15 Casualty or theft loss(es) (other than net qualified disaster losses). Attach federal
Form 4684. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Other Itemized Deductions
16 Other—from list in federal instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
17 Add lines 4, 7, 10, 14, 15, and 16 in columns A, B, and C . . . . . . . . . . . . . . . . . . . . . . . . 17
19 Unreimbursed employee expenses - job travel, union dues, job education, etc.
Attach federal Form 2106 if required. See instructions . . . . . . . . . . . . . . . . . . . . . . . 19
25 Subtract line 24 from line 22. If line 24 is more than line 22, enter 0. ��������������������������������������������������������������������������������������������� 25
29 Is your federal AGI (Form 540, line 13) more than the amount shown below for your filing status?
Single or married/RDP filing separately . . . . . . . . . . . . . . . . . . . . . . . . . . . . $203,341
Yes. Complete the Itemized Deductions Worksheet in the instructions for Schedule CA (540), line 29 . . . . . . . . . . . . . . . . . . . . 29
30 Enter the larger of the amount on line 29 or your standard deduction listed below
Single or married/RDP filing separately. See instructions . . . . . . . . . . . . . . . . $4,601
Married/RDP filing jointly, head of household, or qualifying widow(er) . . . . . . $9,202
DAVID DAUTEL 5 6 0 5 5 0 3 7 8
Before you begin:
If you claim the California Earned Income Tax Credit (EITC) even though you know you are not eligible, you may not be allowed to take the credit for up
to 10 years.
If you are claiming the California EITC, you must provide your date of birth (DOB), and spouse’s/ Registered Domestic Partner’s (RDP’s) DOB if filing
jointly, on your California Form 540, Form 540 2EZ, or Form 540NR.
Do not paper file - not approved
If you qualify for the California EITC you may also qualify for the Young Child Tax Credit (YCTC). See instructions for additional information.
Follow Step 1 through Step 9 in the instructions to determine if you meet the requirements, to complete this form, and to figure the amount of
the credit(s).
Part I Qualifying Information See Specific Instructions.
1 a Has the Internal Revenue Service (IRS) previously disallowed your federal Earned Income Credit (EIC)? . . . . . . □ Yes □ No
b Has the Franchise Tax Board (FTB) previously disallowed your California EITC?. . . . . . . . . . . . . . . . . . . . . . . . . . □ Yes □ No
2 Federal AGI (federal Form 1040 or 1040-SR, line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 2
2953 . 00
5 First name . . . . . . . . . . . . . . . . . . . . .
6 Last name . . . . . . . . . . . . . . . . . . . . .
For Privacy Notice, get FTB 1131 ENG/SP. 214 8461204 FTB 3514 2020 Side 1
Child 1 Child 2 Child 3
12 a Child’s physical address during
2020 (number, street, and apt.
no./ste. no.). See instructions. . . .
b City . . . . . . . . . . . . . . . . . . . . . . . .
c State . . . . . . . . . . . . . . . . . . . . . . .
d ZIP code . . . . . . . . . . . . . . . . . . . .
13 Wages, salaries, tips, and other employee compensation, subject to California withholding. See instructions. . . . . • 13 2953 . 00
b Business address . . . . . . . . . . . . .
d SEIN . . . . . . . . . . . . . . . . . . . . . . .
e Business code . . . . . . . . . . . . . . . .
19 California Earned Income. Add line 16, line 17, and line 18. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 19 2953 . 00
Part V California Earned Income Tax Credit (Complete Step 6 in the instructions.)
20 California EITC. Enter amount from California Earned Income Tax Credit Worksheet, Part III, line 6.
193 . 00
This amount should also be entered on Form 540, line 75; or Form 540 2EZ, line 23. . . . . . . . . . . . . . . . . . . . . . . . • 20
21 CA Exemption Credit Percentage from Form 540NR, line 38. See instructions. . . . . 21 .
22 Nonresident or Part-Year Resident EITC. Multiply line 20 by line 21.
This amount should also be entered on Form 540NR, line 85. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 22 . 00
Part VII Young Child Tax Credit (See Step 8 in the instructions before completing this part.)
23 California Earned Income. Enter the amount from form FTB 3514, line 19. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 . 00
24 Available Young Child Tax Credit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 1,000 . 00
• If the amount on line 23 is $25,000 or less, skip lines 25 through 27 and enter $1,000 on line 28.
If applicable, complete lines 29 and 30.
• If the amount on line 23 is greater than $25,000, complete lines 25 through 28. If applicable,
complete lines 29 and 30.
25 Excess Earned Income over threshold. Subtract $25,000 from line 23. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 25 . 00
26 Divide line 25 by 100. Enter the result as a decimal out to two decimal places, do not round.. . . . . . . . . . . . . . . . 26 .
27 Reduction amount. Multiply line 26 by $20. Enter the result as a decimal out to two decimal places,
do not round. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 27 .
28 Young Child Tax Credit.
• If you did not need to complete lines 25 through 27, your credit is the $1,000 from line 24.
• If you completed lines 25 through 27, to compute your credit, subtract line 27 from line 24. If your credit
amount is between $0 and $1, enter $1. If your credit amount is over $1, round to the nearest whole dollar.
This amount should also be entered on Form 540, line 76; or Form 540 2EZ, line 24. . . . . . . . . . . . . . . . . . . . . . . . • 28 . 00
Part VIII Nonresident or Part-Year Resident Young Child Tax Credit (See Step 9 in the instructions.)
29 CA Exemption Credit Percentage from Form 540NR, line 38. See instructions. . . . . 29 .
30 Nonresident or Part-Year Resident YCTC. Multiply line 28 by line 29.
This amount should also be entered on Form 540NR, line 86. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 30 . 00
Street address (number and street) or PO box Apt. no./ste. no. PMB/private mailbox Daytime telephone number
2025 RAPHAEL CT 5109948355
City State ZIP code
WALNUT CREEK CA 94598
Foreign country name Foreign province/state/county Foreign postal code
For Privacy Notice, get FTB 1131 ENG/SP. FTB 8453-OL 2020