Alvaro Navarro 2020
Alvaro Navarro 2020
OMB No.1545-0074 IRS Use Only—Do not write or staple in this space.
F ilin g Sta tu s ✘ Single Married filing jointly Married filing separately (MFS) Head ofhousehold (HOH) Qualifying widow(er)(QW)
Check only Ifyou checked the MFS box,enter the name ofyour spouse.Ifyou checked the HOH or QW box,enter the child’s name ifthe qualifying
one box.
person is a child but not your dependent ▶
Your firstname and middle initial Lastname Yo u r s o c ia l s e c u rity n u mb e r
Alvaro Navarro 5 5 5 5 5 0 0 0 6
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Ifjointreturn,spouse’s firstname and middle initial Lastname Sp o u s e ’s s o c ia l s e c u r ity n u mb e r
Home address (number and street).Ifyou have a P.O.box,see instructions. Apt.no. Pr e s id e n tia l Ele c tio n Ca mp a ig n
3657 E 55th St Check here if you,or your
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spouse if filing jointly,want $3
City,town,or postoffice.Ifyou have a foreign address,also complete spaces below. State ZIP code
to go to this fund.Checking a
Maywood CA 90270 box below willnot change
Foreign country name Foreign province/state/county Foreign postalcode your tax or refund.
Yo u Sp o u s e
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At any time during 2020,did you receive,sell,send,exchange,or otherwise acquire any financialinterest in any virtualcurrency? Ye s ✘ No
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Ag e /Blin d n e s s Yo u : Were born before January 2,1956 Are blind Sp o u s e : Was born before January 2,1956 Is blind
De p e n d e n ts (see instructions): (2 ) Socialsecurity (3 ) Relationship (4 ) ✔ ifqualifies for (see instructions):
(1 ) Firstname Lastname number to you Child tax credit Credit for other dependents
Ifmore
than four
dependents,
see instructions
and check
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D
here ▶
1 Wages,salaries,tips,etc.Attach Form(s)W-2 . . . . . . . . . . . . . . . . 1 17,546
Attach 2a Tax-exempt interest . . . 2a 2b
b Taxable interest . . . . .
Sch.B if
3a Qualified dividends . . . 3a b Ordinary dividends . . . . . 3b
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required.
4a IRA distributions . . . . 4a 0 b Taxable amount . . . . . . 4b 0
5a Pensions and annuities . . 5a 0 b Taxable amount . . . . . . 5b 0
Sta n d a r d 6a Socialsecurity benefits . . 6a 0 b Taxable amount . . . . . . 6b 0
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De d u c tio n fo r —
7 Capitalgain or (loss).Attach Schedule D ifrequired.Ifnot required,check here . . . . ▶ 7 0
• Single or
Married filing 8 Other income from Schedule 1,line 9 . . . . . . . . . . . . . . . . . . . 8 0
separately,
$12,400 9 Add lines 1,2b,3b,4b,5b,6b,7,and 8.This is your to ta l in c o me . . . . . . . . . ▶ 9 17,546
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• Ifyou checked 12 Sta n d a r d d e d u c tio n o r ite miz e d d e d u c tio n s (from Schedule A) . . . . . . . . . . 12 12,400
any box under
Sta n da rd 13 Qualified business income deduction.Attach Form 8995 or Form 8995-A . . . . . . . . 13 0
De du c tio n ,
see instructions.
14 Add lines 12 and 13 . . . . . . . . . . . . . . . . . . . . . . . . 14 12400
15 T a x a b le in c o me . Subtract line 14 from line 11.Ifzero or less,enter -0- . . . . . . . . . 15 5,146
1040
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F o r Dis c lo s u re , Priv a c y Ac t, a n d Pa p e rwo rk Re d u c tio n Ac t No tic e , s e e s e p a ra te in s tru c tio n s . Cat.No.11320B Form (2020)
Form 1040 (2020) Page 2
16 T a x (see instructions).Check ifany from Form(s): 1 8814 2 4972 3 . . 16 513
17 Amount from Schedule 2,line 3 . . . . . . . . . . . . . . . . . . . . 17 0
18 Add lines 16 and 17 . . . . . . . . . . . . . . . . . . . . . . . . 18 513
19 Child tax credit or credit for other dependents . . . . . . . . . . . . . . . . 19 0
20 Amount from Schedule 3,line 7 . . . . . . . . . . . . . . . . . . . . 20 0
21 Add lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . 21 0
22 Subtract line 21 from line 18.Ifzero or less,enter -0- . . . . . . . . . . . . . . 22 513
23 Other taxes,including self-employment tax,from Schedule 2,line 10 . . . . . . . . . 23 0
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24 Add lines 22 and 23.This is your to ta l ta x . . . . . . . . . . . . . . . . ▶ 24 513
25 Federalincome tax withheld from:
a Form(s)W-2 . . . . . . . . . . . . . . . . . . 25a 859
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b Form(s)1099 . . . . . . . . . . . . . . . . . . 25b 0
c Other forms (see instructions) . . . . . . . . . . . . . 25c 0
d Add lines 25a through 25c . . . . . . . . . . . . . . . . . . . . . . 25d 859
• Ifyou have a 26 2020 estimated tax payments and amount applied from 2019 return . . . . . . . . . . 26
qualifying child, 2 7 Earned income credit (EIC) . . . . . . . . . . .0 . . . 27
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0
attach Sch.EIC.
• Ifyou have 28 Additionalchild tax credit.Attach Schedule 8812 . . . . . 0. . 28 0
nontaxable 29 American opportunity credit from Form 8863,line 8 . . . . . . . 29 0
combatpay,
see instructions. 3 0 Recovery rebate credit.See instructions . . . . . . . . . . 30 1200
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31 Amount from Schedule 3,line 13 . . . . . . . . . . . . 31 0
32 Add lines 27 through 31.These are your to ta l o th e r p a y me n ts a n d r e fu n d a b le c r e d its . . . ▶ 32 1,200
33 Add lines 25d,26,and 32.These are your to ta l p a y me n ts . . . . . .0 . . . . . ▶ 33 2,059
34 Ifline 33 is more than line 24,subtract line 24 from line 33.This is the amount you o v e r p a id . . 34 1,546
Re fu n d
Direct deposit?
35a
▶b
See instructions. ▶
Routing number o
Amount ofline 34 you want r e fu n d e d to y o u . IfForm 8888 is attached,check here . . . ▶
▶ c Type: Checking Savings
35a 1,546
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d Accountnumber
36 Amount ofline 34 you want a p p lie d to y o u r 2 0 2 1 e s tima te d ta x . . ▶ 36
Amo u n t 37 Subtract line 33 from line 24.This is the a mo u n t y o u o we n o w . . . . . . . . . . ▶ 37 0
Yo u Owe No te : Schedule H and Schedule SE filers, line 37 may not represent all of the taxes you owe for
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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 0
T h ir d Pa r ty Do you want to allow another person to discuss this return with the IRS? See
De s ig n e e instructions . . . . . . . . . . . . . . . . . . . . ▶ Ye s . Complete below. ✘ No
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Sig n 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
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belief,they are true,correct,and complete.Declaration of preparer (other than taxpayer)is based on allinformation of which preparer has any knowledge.
He r e Your signature Date Your occupation If the IRS sent you an Identity
Protection PIN,enter it here
▲
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Yes. worksheet and don’t enter any amount on line 30.
2. Does your 2020 return include a valid social security number (defined under Valid social security number, earlier)
for you and, if filing a joint return, your spouse?
✘ Yes. Skip lines 3 and 4, and go to line 5.
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No. If you are filing a joint return, go to line 3.
If you aren't filing a joint return, you can’t take the credit.
Don’t complete the rest of this worksheet and don’t enter any
amount on line 30.
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3. Was at least one of you a member of the U.S. Armed Forces at any time during 2020, and does at least one of you
have a valid social security number (defined under Valid social security number, earlier)?
Yes. Your credit is not limited. Go to line 5.
No. Go to line 4.
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4. Does one of you have a valid social security number (defined under Valid social security number, earlier)?
Yes. Your credit is limited. Go to line 5.
You can’t take the credit. Don’t complete the rest of this
No. worksheet and don’t enter any amount on line 30.
5.
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If your EIP 1 was $1,200 ($2,400 if married filing jointly) plus $500 for each qualifying child you had in 2020,
skip lines 5 and 6, enter zero on lines 7 and 16, and go to line 8. Otherwise, enter:
• $1,200 if single, head of household, married filing separately, qualifying widow(er), or if married filing
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jointly and you answered “Yes” to question 4, or
• $2,400 if married filing jointly and you answered “Yes” to question 2 or 3. . . . . . . . . . . . . . . . . . . . . . . . . . 5. 1200
6. Multiply $500 by the number of qualifying children under age 17 at the end of 2020 listed in the Dependents
section on page 1 of Form 1040 or 1040-SR for whom you either checked the “Child tax credit” box or entered an
adoption taxpayer identification number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. 0
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11. Enter the amount from line 11 of Form 1040 or 1040-SR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 17546
12. Enter the amount shown below for your filing status:
• $150,000 if married filing jointly or qualifying widow(er)
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your signature on this form by conditioning our tax return preparation services on your consent, your consent
will not be valid. If you agree to the disclosure of your tax return information, your consent is valid for the
amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for
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one year from the date of signature.
Defined Terms:
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Address: 820 Northeast 59th Street
Fort Lauderdale FL 33334
"Taxpayer #1": Alvaro Navarro
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"Taxpayer #2":
Address: 3657 E 55th St
Maywood CA 90270
"Taxpayer": Alvaro Navarro
"Personal Information" 3657 E 55th St
"PIN": o Maywood CA 90270
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"Disclosure":
"Purpose":
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CONSENT GRANTED
I/we, the Taxpayer, have read the above information. By typing in my/our taxpayer PIN(s), I/we hereby
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CONSENT DENIED
I/we, the Taxpayer, have read the above information, and by typing in my/our taxpayer PIN(s) hereby
DENY consent to the Use of the Personal Information for the Purpose stated above.
Taxpayer #1 PIN: PIN Entered Date:
Taxpayer #2 PIN: PIN Entered Date:
If you believe your tax return information has been disclosed or used improperly in a manner unauthorized
by law or without your permission, you may contact the Treasury Inspector General for Tax Administration
(TIGTA) by telephone at 1-800-366-4484, or by email at [email protected].
* In accordance with Federal Law and Internal Revenue Code Section 7216, the term 'Tax Preparer' shall mean the ERO of this
electronically filed return even though it may have been prepared by someone other than the ERO.
Consent to Use Personal Tax Return Information
Federal Disclosure:
Federal law requires this consent form be provided to you. Unless authorized by law, we cannot use your
tax return information for purposes other than the preparation and filing of your tax return without your
consent.
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You are not required to complete this form to engage our tax return preparation services. If we obtain
your signature on this form by conditioning our tax return preparation services on your consent, your consent
will not be valid. Your consent is valid for the amount of time that you specify. If you do not specify the
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duration of your consent, your consent is valid for one year from the date of signature.
Defined Terms:
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Address: 820 Northeast 59th Street
Fort Lauderdale FL 33334
"Taxpayer #1": Alvaro Navarro
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"Taxpayer #2":
Address: 3657 E 55th St
Maywood CA 90270
"Taxpayer": Alvaro Navarro
"Personal Information" 3657 E 55th St
"PIN": o Maywood CA 90270
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"Use":
"Purpose":
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CONSENT GRANTED
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I/we, the Taxpayer, have read the above information and by typing in my/our taxpayer PIN(s) hereby
consent to Tax Preparer's Use of the Personal Information for the Purpose stated above.
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CONSENT DENIED
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I/we, the Taxpayer, have read the above information, and by typing in my/our taxpayer PIN(s) hereby
DENY consent to the Use of the Personal Information for the Purpose stated above.
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If you believe your tax return information has been disclosed or used improperly in a manner unauthorized
by law or without your permission, you may contact the Treasury Inspector General for Tax Administration
(TIGTA) by telephone at 1-800-366-4484, or by email at [email protected].
* In accordance with Federal Law and Internal Revenue Code Section 7216, the term 'Tax Preparer' shall mean the ERO of this
electronically filed return even though it may have been prepared by someone other than the ERO.
Form 8948
(Rev. September 2018)
Preparer Explanation for Not Filing Electronically OMB No. 1545-2200
Department of the Treasury ▶ Go to www.irs.gov/Form8948 for instructions and the latest information. Attachment
Internal Revenue Service Sequence No. 173
Name(s) on tax return Tax year of return Taxpayer’s identifying number
Alvaro Navarro 2020 555-55-0006
Preparer’s name Preparer Tax Identification Number (PTIN)
Martin Camilo Ortegon P00000000
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Three out of four taxpayers now use IRS e-file. Go to www.irs.gov/efile for details on using IRS e-file. The benefits of
electronic filing include the following.
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• Faster refunds • Secure transmissions • E-payment options
• More accurate returns • Easier filing method • Receipt acknowledged
Check the applicable box to indicate the reason this return is not being filed electronically. Do not check more than one box.
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1 Taxpayer chose to file this return on paper.
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2 The preparer received a waiver from the requirement to electronically file the tax return.
3
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The preparer is a member of a recognized religious group that is conscientiously opposed to filing electronically.
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4 This return was rejected by IRS e-file and the reject condition could not be resolved.
5 The preparer’s e-file software package does not support Form or Schedule
attached to this return.
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6 Check the box that applies and provide additional information if requested.
a The preparer is ineligible to file electronically because IRS e-file does not accept foreign preparers without social security
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c Other: Describe below the circumstances that prevented the preparer from filing this return electronically.
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For Paperwork Reduction Act Notice, see instructions. Cat. No. 37766D Form 8948 (Rev. 9-2018)
a Employee’s social security number Safe, accurate, Visit the IRS website at
5 5 5 - 5 5 - 0 0 0 6 OMB No. 1545-0008 FAST! Use www.irs.gov/efile
b Employer identification number (EIN) 1 Wages, tips, other compensation 2 Federal income tax withheld
8 2 1 5 7 8 1 5 5 ELEC 12,418 614
c Employer’s name, address, and ZIP code 3 Social security wages 4 Social security tax withheld
Electronica centauro 12,418 770
5 Medicare wages and tips 6 Medicare tax withheld
789 main St 12,418 180
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Long Beach 7 Social security tips 8 Allocated tips
CA 90806
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e Employee’s first name and initial Last name Suff. 11 Nonqualified plans 12a See instructions for box 12
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Alvaro Navarro d
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Form W-2 Wage and Tax Statement
Copy B—To Be Filed With Employee’s FEDERAL Tax Return.
2020 Department of the Treasury—Internal Revenue Service
b Employer identification number (EIN) 1 Wages, tips, other compensation 2 Federal income tax withheld
8 2 1 4 4 5 1 8 7 TORT 5,128 245
c Employer’s name, address, and ZIP code 3 Social security wages 4 Social security tax withheld
Tortilleria ACME 5,128 318
5 Medicare wages and tips 6 Medicare tax withheld
456 Any St 5,128 74
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Long Beach 7 Social security tips 8 Allocated tips
CA 90806
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e Employee’s first name and initial Last name Suff. 11 Nonqualified plans 12a See instructions for box 12
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Alvaro Navarro d
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Form W-2 Wage and Tax Statement
Copy B—To Be Filed With Employee’s FEDERAL Tax Return.
2020 Department of the Treasury—Internal Revenue Service
Taxpayer/
17,546 0
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0 0
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0 0
5. Allocated tips 0 0
0 0
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7. Additional income on W-2 0
0 0
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9a. Exempt interest dividends 0 0
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0
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12. Business income or loss 0 0
0 0
0 0
0 0
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0 0
29. Self-employed health insurance deduction
0 0
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0
0 0
32. IRA deduction
0
0
34. Tuition and fees deduction
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0
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0
0 0
555-55-0006 NAVA 20
ALVARO NAVARRO
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3657 E 55TH ST
MAYWOOD CA 90270
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01-01-1995
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Enter your county at time of filing (see instructions)
Principal Residence
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If your address above is the same as your principal/physical residence address at the time of filing, check this box. . .
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.
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3657 E 55TH ST
City State ZIP code
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MAYWOOD CA 90270
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.
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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 0 X $124 = $ 0
9 Senior: If you (or your spouse/RDP) are 65 or older, enter 1;
if both are 65 or older, enter 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . •9 0 X $124 = $ 0
Last Name
Exemptions
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SSN. See
instructions. • • •
Dependent’s
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relationship
to you
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11 Exemption amount: Add line 7 through line 10. Transfer this amount to line 32 . . . . . . . . . . . . . 11 $ 124
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13 Enter federal adjusted gross income from federal Form 1040 or 1040-SR, line 11 . . . . . . . . 13
17546 . 00
14 California adjustments – subtractions. Enter the amount from Schedule CA (540),
Part I, line 23, column B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 14
0 . 00
15 Subtract line 14 from line 13. If less than zero, enter the result in parentheses.
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See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
17546 . 00
Taxable Income
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16 California adjustments – additions. Enter the amount from Schedule CA (540),
Part I, line 23, column C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 16
0 . 00
• 17546 . 00
{ {
17 California adjusted gross income. Combine line 15 and line 16 . . . . . . . . . . . . . . . . . . . . . . . 17
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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:
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✘
Tax Table Tax Rate Schedule
31 Tax. Check the box if from:
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33 Subtract line 32 from line 31. If less than zero, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
45 . 00
• . 00
Special Credits
45 To claim more than two credits. See instructions. Attach Schedule P (540) . . . . . . . . . . . . . • 45
0 . 00
Special Credits
47 Add line 40 through line 46. These are your total credits . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
0 . 00
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48 Subtract line 47 from line 35. If less than zero, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 45 . 00
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61 Alternative Minimum Tax. Attach Schedule P (540) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 61 0 . 00
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63 Other taxes and credit recapture. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 63 0 . 00
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65 Add line 48, line 61, line 62, line 63, and line 64. This is your total tax . . . . . . . . . . . . . . . . . • 65 45 . 00
71
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California income tax withheld. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 71
121 . 00
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72 2020 CA estimated tax and other payments. See instructions . . . . . . . . . . . . . . . . . . . . . . . . • 72 . 00
• 0 . 00
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• 0 . 00
Use Tax
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If line 91 is zero, check if: ✘ No use tax is owed. You paid your use tax obligation directly to CDTFA.
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• 0 . 00
Penalty
93 Payments balance. If line 78 is more than line 91, subtract line 91 from line 78 . . . . . . . . . . 93 121 . 00
94 Use Tax balance. If line 91 is more than line 78, subtract line 78 from line 91 . . . . . . . . . . . 94 0 . 00
95 Payments after Individual Shared Responsibility Penalty. If line 93 is more than line 92,
subtract line 92 from line 93. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 121 . 00
96 Individual Shared Responsibility Penalty Balance. If line 92 is more than line 93, then
subtract line 93 from line 92. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
0 . 00
97 Overpaid tax. If line 95 is more than line 65, subtract line 65 from line 95 . . . . . . . . . . . . . . 97
76 . 00
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99 Overpaid tax available this year. Subtract line 98 from line 97 . . . . . . . . . . . . . . . . . . . . . . . . • 99 76 . 00
100 Tax due. If line 95 is less than line 65, subtract line 95 from line 65 . . . . . . . . . . . . . . . . . . . 100 0 . 00
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Code Amount
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Alzheimer’s Disease and Related Dementia Voluntary Tax Contribution Fund . . . . . . . . . . . . • 401 . 00
Rare and Endangered Species Preservation Voluntary Tax Contribution Program . . . . . . . . . • 403 . 00
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California Breast Cancer Research Voluntary Tax Contribution Fund . . . . . . . . . . . . . . . . . . . • 405 . 00
•
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Protect Our Coast and Oceans Voluntary Tax Contribution Fund . . . . . . . . . . . . . . . . . . . . . . • 424 . 00
• . 00
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Prevention of Animal Homelessness and Cruelty Voluntary Tax Contribution Fund . . . . . . . . 431
110 Add code 400 through code 444. This is your total contribution . . . . . . . . . . . . . . . . . . . . . . • 110
0 . 00
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 0 . 00
Pay Online – Go to ftb.ca.gov/pay for more information.
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112 Interest, late return penalties, and late payment penalties . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 . 00
Interest and
Penalties
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Check the box: • FTB 5805 attached • FTB 5805F attached . . . . . . . . . . . • 113
0 . 00
114 Total amount due. See instructions. Enclose, but do not staple, any payment . . . . . . . . . . . . 114
0 . 00
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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 76 . 00
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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 o • 116 Direct deposit amount
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0 . 00
Savings
The remaining amount of my refund (line 115) is authorized for direct deposit into the account shown below:
• Type
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. 00
Savings
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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
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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)
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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)
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It is unlawful
to forge a
spouse’s/
Firm’s name (or yours, if self-employed) • PTIN
RDP’s MARTIN ORTEGON P00000000
signature.
Firm’s address • Firm’s FEIN
Joint tax
return? 820 NORTHEAST 59TH STREET FORT LAUDERDALE FL 33334
(See
instructions)
Do you want to allow another person to discuss this tax return with us? See instructions . . . . . . • Yes No
Print Third Party Designee’s Name Telephone Number
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17546 0
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