Client Information SheetForm Selection

Check appropriate form you are filling in

1040

1040A

1040EZ

1040NR

1040EZ-T

1040 SS (PR)

Extension To file Form

Filling Status

Single

Married filling jointly (even if one had income)

Married filling separately

Did your spouse live with you this year? Yes No

Did both of you live together at any time after June 30th of this year? Yes No

Did your spouse itemize deductions? Yes No

Head of House Hold

If qualifying person is child but not your dependent,

Enter Child’s name SSN

You are using filling status 4 and claiming NRA spouse

Qualifying widow(er) with dependent child (year spouse died)

✔

✔

Personal Information

Taxpayer Spouse

SSN / ITIN

First Name and Initial

Last Name

Suffix

Date Of Birth

Cell Number

Telephone Number (Home)

Telephone Number (Work)

Extension For Telephone Number (Work)

Email Address

Occupation

Date of death, only if in Last year or this year

Surviving Spouse

Personal Representative / Legal Heirs

Blind? Yes No Yes No

Student?

Permanently Disabled?

Check if someone can claim you as a dependent

Do you want $3 to go to Presidential Election fund Yes No Yes No

Check this box if you have field returns in U.S Possessions in the prior year

If the above box is Checked you are not eligible to claim Earned Income Tax Credit on Electronically filed returns.

U.S. Address / U.S. Possession Address

In care of Name Apt. No.

Street Address

City State ZIP Code

Foreign Address

Street Address

Country

PostalCode City ProvinceOrState

If you excluding Puerto Rico income, Enter the amount here

Select Special processing if applicable

If Special Processing = Combate Zone then enter the deployment date

Disaster designation

7143 MYRTLE AVENUE

ALEJANDRO

02/18/1981

GARIBAY

PROJECT MANAGER

CA

(562)587-7205

90805

✔

LONG BEACH

615-88-8657

Dependents

Note: To claim a foster child as qualifying child for any of the tax benefits, the child must be placed with you by an Authorized placement agency or by judgment, decree or other order of any court of component jurisdiction. A foster child no longer qualifies you to use qualifying widow(er) filling status.

If more than four dependents click here

Dependent 1 Dependent 2 Dependent 3 Dependent 4

First Name

Last Name

SSN / TIN

Date Of Birth

Relationship

Dependent Type

(Dependent type: 0-Not Dependent, 1-lives with, 2-lives apart, 3-Others)

Months In Home

Cared As Child?

Claiming Education Credit? Yes No Yes No Yes No Yes No

Claiming American Opportunity Credit?

Yes No Yes No Yes No Yes No

Claiming Lifetime Learning Credit? Yes No Yes No Yes No Yes No

Claiming Dependent Care Credit? Yes No Yes No Yes No Yes No

Claiming for Earned Income Credit? Yes No Yes No Yes No Yes No

Is Dependent a student? Yes No Yes No Yes No Yes No

Is Dependent Disabled? Yes No Yes No Yes No Yes No

Is Dependent kidnapped in Current year?

Yes No Yes No Yes No Yes No

Eligible for Child Tax Credit? Yes No Yes No Yes No Yes No

Special circumstances child? Yes No Yes No Yes No Yes No

Note: Select "Special Circumstances" if dependent is used as a qualifying child for HOH filing status/EIC but will not be claimed for a dependent exemption.

✔

✔

PEREZ

✔

✔

0

✔

✔

✔

✔

0

VANESSAITZIA GUADALUPE

YES

✔

1

✔

YES

AVALOS AVILA

NIECE

✔

✔

✔

621-83-5995

✔

✔

✔

✔

01/14/2000

✔

✔

12

✔

NIECE

09/26/2010

✔

✔

680-20-6853

0

Return Information SheetIndividual Income Tax Return

Type of ReturnYou Are Preparing

Federal OnlyFederal & State

Return TypeE-FilePaper

Signature AuthorizationAre you first time filer? Yes NoCheck if filling any of following forms

Form 3115Form 3468Form 4136Form 5713Form 8283 (Section B is completed)Form 8332Form 8858Form 8885

Electronic Signature (PIN) EligibilityYou can use Practitioner PIN MethodYou can not use Practitioner PIN Method

File Form 8453Electronic Signature (PIN)

Taxpayer PINSpouse PINPractitioner PIN

Form 8453

◆

◆

◆

◆

17568

◆

17242

Refund/Payment OptionBank Product Select BankDirect DepositDirect DebitPaper CheckExtension Filed - No Payment

Bank Account InformationIf you want your refund to be deposited into more than one bank accounts then check here (FORM 8888)

Routing NumberAccount NumberAccount Type Savings CheckingAre You Making Payment with this Return? Yes NoThird Party DesigneeDo you want another person to discuss this return with IRS? Yes NoNameTelephonePIN

Preparer InformationPreparer's IDPreparer's NamePreparer's SSNPreparer TINFirm NameAddressCity - State - ZIP CodeEmail AddressNon-Paid Preparer IndicatorDateSelf Employed? Yes NoEINTelephoneFax

DOWNEY

03/17/2014

90240

322271627

◆

ZEVCO

MONICA C ZEVALLOS

◆

P01-065479

◆

4883430848

7857 E FLORENCE AVE STE 208

(562)806-2144

90-0544871

(562)806-2540

CA

Preparer Foreign AddressForeign AddressCountryPostalCode City ProvinceOrState

Form 1040 Department of the Treasury—Internal Revenue Service

OMB No. 1545-0074

(99)

IRS Use Only—Do not write or staple in this space. U.S. Individual Income Tax Return 2013For the year Jan. 1–Dec. 31, 2013, or other tax year beginning , 2013, ending , 20 See separate instructions.Your first name and initial Last name Your social security number

If a joint return, spouse’s first name and initial Last name Spouse’s social security number

▲ Make sure the SSN(s) above and on line 6c are correct.

Home address (number and street). If you have a P.O. box, see instructions. Apt. no.

City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions).

Foreign country name Foreign province/state/county Foreign postal code

Presidential Election Campaign

Check here if you, or your spouse if filing jointly, want $3 to go to this fund. Checking a box below will not change your tax or refund.

You Spouse

Filing Status

Check only one box.

1 Single 2 Married filing jointly (even if only one had income) 3 Married filing separately. Enter spouse’s SSN above and

full name here. ▶

4 Head of household (with qualifying person). (See instructions.) If the

qualifying person is a child but not your dependent, enter this child’s

name here. ▶

5 Qualifying widow(er) with dependent child

Exemptions 6a Yourself. If someone can claim you as a dependent, do not check box 6a . . . . . . .b Spouse . . . . . . . . . . . . . . . . . . . . . . . . }c Dependents:

(1) First name Last name

(2) Dependent’s social security number

(3) Dependent’s relationship to you

(4) ✓ if child under age 17 qualifying for child tax credit

(see instructions)

If more than four dependents, see instructions and check here ▶

d Total number of exemptions claimed . . . . . . . . . . . . . . . . . .

Boxes checked on 6a and 6bNo. of children on 6c who: • lived with you • did not live with you due to divorce or separation (see instructions)

Dependents on 6c not entered above

Add numbers on lines above ▶

Income

Attach Form(s) W-2 here. Also attach Forms W-2G and 1099-R if tax was withheld.

If you did not get a W-2, see instructions.

7 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . 7 8a Taxable interest. Attach Schedule B if required . . . . . . . . . . . . . 8a

b Tax-exempt interest. Do not include on line 8a . . . . 8b 9 a Ordinary dividends. Attach Schedule B if required . . . . . . . . . . . . 9a

b Qualified dividends . . . . . . . . . . . . 9b 10 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . . . 10 11 Alimony received . . . . . . . . . . . . . . . . . . . . . 11 12 Business income or (loss). Attach Schedule C or C-EZ . . . . . . . . . . . . 12 13 Capital gain or (loss). Attach Schedule D if required. If not required, check here ▶ 13 14 Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . . 14 15 a IRA distributions . 15a b Taxable amount . . . . 15b 16 a Pensions and annuities 16a b Taxable amount . . . . 16b 17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E 17 18 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . . 18 19 Unemployment compensation. . . . . . . . . . . . . . . . . . 19 20 a Social security benefits 20a b Taxable amount . . . . 20b 21 Other income. List type and amount 21 22 Combine the amounts in the far right column for lines 7 through 21. This is your total income ▶ 22

Adjusted Gross Income

23 Educator expenses . . . . . . . . . . . 23 24 Certain business expenses of reservists, performing artists, and fee-

basis government officials. Attach Form 2106 or 2106-EZ 24 25 Health savings account deduction. Attach Form 8889 . . 25 26 Moving expenses. Attach Form 3903 . . . . . . . 26 27 Deductible part of self-employment tax. Attach Schedule SE . . 27 28 Self-employed SEP, SIMPLE, and qualified plans . . . . 28 29 Self-employed health insurance deduction . . . . . 29 30 Penalty on early withdrawal of savings . . . . . . 30 31 a Alimony paid b Recipient’s SSN ▶ 31a 32 IRA deduction . . . . . . . . . . . . . 32 33 Student loan interest deduction . . . . . . . . 33 34 Tuition and fees. Attach Form 8917 . . . . . . . 34 35 Domestic production activities deduction. Attach Form 8903 35 36 Add lines 23 through 35 . . . . . . . . . . . . . . . . . . . 36 37 Subtract line 36 from line 22. This is your adjusted gross income . . . . . . . ▶ 37

For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 11320B Form 1040 (2013)

66442

NIECE

ALEJANDRO

0

66442

193

0

0

✔

✔

1

NIECE

GARIBAY

✔

0

-5942

6 8 0 2 0 6 8 5 3VANESSA AVALOS AVILA

0

✔

2

ITZIA GUADALUPE PEREZ

7216130

0

0

7143 MYRTLE AVENUE

3

0

6 2 1 8 3 5 9 9 5

0

6 1 5 8 8 8 6 5 7

0

LONG BEACH, CA, 90805

Form 1040 (2013) Page 2

Tax and Credits

38 Amount from line 37 (adjusted gross income) . . . . . . . . . . . . . . . 38 39a Check

if: { You were born before January 2, 1949, Blind. Spouse was born before January 2, 1949, Blind. } Total boxes

checked ▶ 39a b If your spouse itemizes on a separate return or you were a dual-status alien, check here ▶ 39b Standard

Deduction for— • People who check any box on line 39a or 39b or who can be claimed as a dependent, see instructions.• All others: Single or Married filing separately, $6,100 Married filing jointly or Qualifying widow(er), $12,200 Head of household, $8,950

40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) . . . . 4041 Subtract line 40 from line 38 . . . . . . . . . . . . . . . . . . . . 41 42 Exemptions. If line 38 is $150,000 or less, multiply $3,900 by the number on line 6d. Otherwise, see instructions . . 42 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- . . . . 43 44 Tax (see instructions). Check if any from: a Form(s) 8814 b Form 4972 c 44 45 Alternative minimum tax (see instructions). Attach Form 6251 . . . . . . . . . . 45 46 Add lines 44 and 45 . . . . . . . . . . . . . . . . . . . . . ▶ 46 47 Foreign tax credit. Attach Form 1116 if required . . . . . . 47 48 Credit for child and dependent care expenses. Attach Form 2441 48 49 Education credits from Form 8863, line 19 . . . . . . . 49 50 Retirement savings contributions credit. Attach Form 8880 50 51 Child tax credit. Attach Schedule 8812, if required . . . . . 51 52 Residential energy credits. Attach Form 5695. . . . . . 52 53 Other credits from Form: a 3800 b 8801 c 5354 Add lines 47 through 53. These are your total credits . . . . . . . . . . . . . 5455 Subtract line 54 from line 46. If line 54 is more than line 46, enter -0- . . . . . . . . ▶ 55

Other Taxes

56 Self-employment tax. Attach Schedule SE . . . . . . . . . . . . . . . . 56 57 Unreported social security and Medicare tax from Form: a 4137 b 8919 . . 57 58 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required . . . . 5859a 59a

b 59bHousehold employment taxes from Schedule H . . . . . . . . . . . . . . .

First-time homebuyer credit repayment. Attach Form 5405 if required . . . . . . . . .

60 Taxes from: a Form 8959 b Form 8960 c Instructions; enter code(s) 6061 Add lines 55 through 60. This is your total tax . . . . . . . . . . . . . . ▶ 61

Payments 62 Federal income tax withheld from Forms W-2 and 1099 . . . . 6263 2013 estimated tax payments and amount applied from 2012 return 63

If you have a qualifying child, attach Schedule EIC.

64a Earned income credit (EIC) . . . . . . . . . . . 64a b Nontaxable combat pay election 64b

65 Additional child tax credit. Attach Schedule 8812 . . . . . . 6566 American opportunity credit from Form 8863, line 8 . . . . 6667 Reserved . . . . . . . . . . . . . . . . 6768 Amount paid with request for extension to file . . . . . . 6869 Excess social security and tier 1 RRTA tax withheld . . . . . . 6970 Credit for federal tax on fuels. Attach Form 4136 . . . . . 7071 Credits from Form: a 2439 b Reserved c 8885 d 7172 Add lines 62, 63, 64a, and 65 through 71. These are your total payments . . . . . . . ▶ 72

Refund

Direct deposit? See instructions.

73 If line 72 is more than line 61, subtract line 61 from line 72. This is the amount you overpaid 7374a Amount of line 73 you want refunded to you. If Form 8888 is attached, check here . . . ▶ 74a

▶

▶b Routing number ▶ c Type: Checking Savingsd Account number

75 Amount of line 73 you want applied to your 2014 estimated tax ▶ 75Amount You Owe

76 Amount you owe. Subtract line 72 from line 61. For details on how to pay, see instructions ▶ 7677 Estimated tax penalty (see instructions) . . . . . . . . 77

Third Party Designee

Do you want to allow another person to discuss this return with the IRS (see instructions)? Yes. Complete below. No

Designee’s name ▶

Phone no. ▶

Personal identification number (PIN) ▶

Sign Here Joint return? See instructions. Keep a copy for your records.

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.

Your signature Date Your occupation Daytime phone number

Spouse’s signature. If a joint return, both must sign.

▲

Date Spouse’s occupation If the IRS sent you an Identity Protection PIN, enter it here (see inst.)

Paid Preparer Use Only

Print/Type preparer’s name Preparer’s signature Date Check if self-employed

PTIN

Firm’s name ▶

Firm’s address ▶

Firm's EIN ▶

Phone no.

Form 1040 (2013)

11700

P01-065479

0

66442

0

0

3799

25181

3799

0

3 2 2 2 7 1 6 2 7

41261

600

0

4 8 8 3 4 3 0 8 4 8

90-05448717857 E FLORENCE AVE STE 208, DOWNEY, CA, 90240

0

✔

1990

0

0

ZEVCO

(562)587-7205

✔

PROJECT MANAGER

1199

(562)806-2144

19901199

2000

791

0

0

791

0

MONICA C ZEVALLOS✔

26000

29561

Child Tax Credit Worksheet and Carryovers Worksheet

Name: SSN:

Child Tax Credit (CTC)

1. $1000 x Number of qualifying children

2. Modified AGI

3. Modified AGI limitation

4. Subtract Line 3 from Line 2, If zero enter zero

5. Round to nearest $1000

6. Multiply the amount on line 5 by 5%

7. Maximum Child tax credit. Subtract Line 6 from Line 1 You cannot take the credit if zero

8. Amount from Form 1040 Line 44 , Form 1040A Line 28, Form 1040NR line 44.

9. Add the amounts from Form 1040 Line 47 to Line 50 Or Form 1040A Line 29 to Line 32, Form 1040NR line 45 to Line 47 Plus credits from form 5695, form 8834, form 8910 , form 8936 , schedule R Line 22

10. Taxable earned income

11. Limit of earned income

12. Amount from Form W2 box 6 , box 4 , box 12, codes A B M N + RRTA 1+ Form 1040 Line (29+57) Form 1040 Line (29+57)

13. Earned Income Credit / Excess RRTA / FICA Tax

14. Subtract line 13 from line 12

15. Enter the larger of Line 11 or line 14

16. Subtract line 15 from line 7

17. Total of Residential credit, Mortgage Interest credit, District of columbia first timehomebuyer credit

18. Add lines 17 and line 9.

19. Subtract line 18 from line 8.

20. Child Tax credit. Enter smaller of line 7 or line 19.

2

72161

10374

5520

600

2000

3199

0

600

0

0

5520

2000

3799

66442

0

0

75000

10374

615-88-8657ALEJANDRO

2000

0

Form 1040 State and Local Income

Tax Refund Worksheet-Line 10

Note: Use the spouse column only if filing status is married

filing jointly for this year and filing status was married filing

separately last year.

Joint or

TaxPayer Spouse

1. Enter the income tax refund from Form(s) 1099-G (or similar statement). But do not enter more than the amount of your state and local income taxes shown on your 2010 Schedule A, line 5 . . .

2. Enter your total itemized deductions from your 2010 Schedule A, line 29. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Note. If the filing status on your 2010 Form 1040 was married filing separately and your spouse

itemized deductions in 2010, skip lines 3 through 7, enter the amount from line 2 on line 8, and

go to line 9.

3. Enter the amount shown below for the filing status claimed on your 2010 Form 1040.

· Single or married filing separately—$5,700

· Married filing jointly or qualifying widow(er)—$11,400

· · Head of household—$8,400

4. Did you fill in line 39a on your 2010 Form 1040? No. Enter -0-. Yes. Multiply the number in the box on line 39a of your 2010 Form 1040 by $1,100 ($1,400 if your 2010 filing status was single or head of household). . . . . . . . . . . . . . . . . . . . . . . . . . .

5. Enter any net disaster loss from your 2010 Form 4684, line 17 . . . .

6. Enter any new motor vehicle taxes shown on your 2010 Schedule A, line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7. Add lines 3, 4, 5, and 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8. Is the amount on line 7 less than the amount on line 2? No. STOP None of your refund is taxable. Yes. Subtract line 7 from line 2 . . . . . . . . . . . . . . . . . . . . . . . . .

9. Taxable part of your refund. Enter the smaller of line 1 or line 8 here and on Form 1040, line 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

0

0

0

0

193

4962

7400

1

5950

193

1450

1

12362

0

22222 Voida Employee’s social security number For Official Use Only ?

OMB No. 1545-0008

b Employer identification number (EIN)

c Employer’s name, address, and ZIP code

d Control number

e Employee’s first name and initial Last name Suff.

f Employee’s address and ZIP code

1 Wages, tips, other compensation 2 Federal income tax withheld

3 Social security wages 4 Social security tax withheld

5 Medicare wages and tips 6 Medicare tax withheld

7 Social security tips 8 Allocated tips

9 10 Dependent care benefits

11 Nonqualified plans 12a See instructions for box 12Co d e

12bCo d e

12cCo d e

12dCo d e

13 Statutory employee

Retirement plan

Third-party sick pay

14 Other

15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name

Form W-2 Wage and Tax Statement 2013Copy A For Social Security Administration — Send this entire page with Form W-3 to the Social Security Administration; photocopies are not acceptable.

Department of the Treasury—Internal Revenue Service

For Privacy Act and Paperwork Reduction

Act Notice, see the separate instructions.

Cat. No. 10134D

Do Not Cut, Fold, or Staple Forms on This Page

CGARIBAY

1046

✔

1990

LONG BEACH

2244 WALNUT GROVE AVENUE

437ALEJANDRO

72161

72161

CA

7143 MYRTLE AVENUE

91770

DD

95972161

717

5484

4474SOUTHERN CALIFORNIA EDISON CO

90805

615-88-8657

CA

00153833

ROSEMEAD

CA VDI

72161

CA

95-1240335 SOUT

SCHEDULE B (Form 1040A or 1040)

Department of the Treasury Internal Revenue Service (99)

Interest and Ordinary Dividends▶ Attach to Form 1040A or 1040.

▶ Information about Schedule B (Form 1040A or 1040) and its instructions is at www.irs.gov/scheduleb.

OMB No. 1545-0074

2013Attachment Sequence No. 08

Name(s) shown on return Your social security number

Part I

Interest

(See instructions on back and the instructions for Form 1040A, or Form 1040, line 8a.) Note. If you received a Form 1099-INT, Form 1099-OID, or substitute statement from a brokerage firm, list the firm’s name as the payer and enter the total interest shown on that form.

1

List name of payer. If any interest is from a seller-financed mortgage and the buyer used the property as a personal residence, see instructions on back and list this interest first. Also, show that buyer’s social security number and address ▶

1

Amount

2 Add the amounts on line 1 . . . . . . . . . . . . . . . . . . 2 3

Excludable interest on series EE and I U.S. savings bonds issued after 1989. Attach Form 8815 . . . . . . . . . . . . . . . . . . . . . 3

4

Subtract line 3 from line 2. Enter the result here and on Form 1040A, or Form 1040, line 8a . . . . . . . . . . . . . . . . . . . . . . ▶ 4

Note. If line 4 is over $1,500, you must complete Part III. Amount

Part II

Ordinary Dividends (See instructions on back and the instructions for Form 1040A, or Form 1040, line 9a.)

Note. If you received a Form 1099-DIV or substitute statement from a brokerage firm, list the firm’s name as the payer and enter the ordinary dividends shown on that form.

5 List name of payer ▶

5

6

Add the amounts on line 5. Enter the total here and on Form 1040A, or Form 1040, line 9a . . . . . . . . . . . . . . . . . . . . . . ▶ 6

Note. If line 6 is over $1,500, you must complete Part III.

Part III Foreign Accounts and Trusts (See instructions on back.)

You must complete this part if you (a) had over $1,500 of taxable interest or ordinary dividends; (b) had a foreign account; or (c) received a distribution from, or were a grantor of, or a transferor to, a foreign trust. Yes No

7a At any time during 2013, did you have a financial interest in or signature authority over a financial account (such as a bank account, securities account, or brokerage account) located in a foreign country? See instructions . . . . . . . . . . . . . . . . . . . . . . . .If “Yes,” are you required to file FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR), formerly TD F 90-22.1, to report that financial interest or signature authority? See FinCEN Form 114 and its instructions for filing requirements and exceptions to those requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b If you are required to file FinCEN Form 114, enter the name of the foreign country where the financial account is located ▶

8 During 2013, did you receive a distribution from, or were you the grantor of, or transferor to, a foreign trust? If “Yes,” you may have to file Form 3520. See instructions on back . . . . . .

For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 17146N Schedule B (Form 1040A or 1040) 2013

30

30PENNYMAC

0

Interest SubTotal

ALEJANDRO GARIBAY

✔

0

615-88-8657

30

✔

SCHEDULE C (Form 1040)

Department of the Treasury Internal Revenue Service (99)

Profit or Loss From Business (Sole Proprietorship)

▶ For information on Schedule C and its instructions, go to www.irs.gov/schedulec.

▶ Attach to Form 1040, 1040NR, or 1041; partnerships generally must file Form 1065.

OMB No. 1545-0074

2013Attachment

Sequence No. 09 Name of proprietor Social security number (SSN)

A Principal business or profession, including product or service (see instructions) B Enter code from instructions

▶

C Business name. If no separate business name, leave blank. D Employer ID number (EIN), (see instr.)

E Business address (including suite or room no.) ▶

City, town or post office, state, and ZIP code

F Accounting method: (1) Cash (2) Accrual (3) Other (specify) ▶

G Did you “materially participate” in the operation of this business during 2013? If “No,” see instructions for limit on losses . Yes No

H If you started or acquired this business during 2013, check here . . . . . . . . . . . . . . . . . ▶

I Did you make any payments in 2013 that would require you to file Form(s) 1099? (see instructions) . . . . . . . . Yes No

J If "Yes," did you or will you file required Forms 1099? . . . . . . . . . . . . . . . . . . . . . Yes No

Part I Income

1 Gross receipts or sales. See instructions for line 1 and check the box if this income was reported to you on

Form W-2 and the “Statutory employee” box on that form was checked . . . . . . . . . ▶ 1

2 Returns and allowances . . . . . . . . . . . . . . . . . . . . . . . . . 2

3 Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . 3

4 Cost of goods sold (from line 42) . . . . . . . . . . . . . . . . . . . . . . 4

5 Gross profit. Subtract line 4 from line 3 . . . . . . . . . . . . . . . . . . . . 5

6 Other income, including federal and state gasoline or fuel tax credit or refund (see instructions) . . . . 6

7 Gross income. Add lines 5 and 6 . . . . . . . . . . . . . . . . . . . . . ▶ 7

Part II Expenses Enter expenses for business use of your home only on line 30.

8 Advertising . . . . . 8

9

Car and truck expenses (see

instructions) . . . . . 9

10 Commissions and fees . 10

11 Contract labor (see instructions) 11

12 Depletion . . . . . 12

13

Depreciation and section 179 expense deduction (not included in Part III) (see instructions) . . . . . 13

14

Employee benefit programs

(other than on line 19) . . 14

15 Insurance (other than health) 15

16 Interest:

a Mortgage (paid to banks, etc.) 16a

b Other . . . . . . 16b

17 Legal and professional services 17

18 Office expense (see instructions) 18

19 Pension and profit-sharing plans . 19

20 Rent or lease (see instructions):

a Vehicles, machinery, and equipment 20a

b Other business property . . . 20b

21 Repairs and maintenance . . . 21

22 Supplies (not included in Part III) . 22

23 Taxes and licenses . . . . . 23

24 Travel, meals, and entertainment:

a Travel . . . . . . . . . 24a

b

Deductible meals and

entertainment (see instructions) . 24b

25 Utilities . . . . . . . . 25

26 Wages (less employment credits) . 26

27 a Other expenses (from line 48) . . 27a

b Reserved for future use . . . 27b

28 Total expenses before expenses for business use of home. Add lines 8 through 27a . . . . . . ▶ 28

29 Tentative profit or (loss). Subtract line 28 from line 7 . . . . . . . . . . . . . . . . . 29

30 Expenses for business use of your home. Do not report these expenses elsewhere. Attach Form 8829

unless using the simplified method (see instructions).

Simplified method filers only: enter the total square footage of: (a) your home:

and (b) the part of your home used for business: . Use the Simplified

Method Worksheet in the instructions to figure the amount to enter on line 30 . . . . . . . . . 30

31 Net profit or (loss). Subtract line 30 from line 29.

• If a profit, enter on both Form 1040, line 12 (or Form 1040NR, line 13) and on Schedule SE, line 2.

(If you checked the box on line 1, see instructions). Estates and trusts, enter on Form 1041, line 3.

• If a loss, you must go to line 32.} 31

32 If you have a loss, check the box that describes your investment in this activity (see instructions).

• If you checked 32a, enter the loss on both Form 1040, line 12, (or Form 1040NR, line 13) and

on Schedule SE, line 2. (If you checked the box on line 1, see the line 31 instructions). Estates and

trusts, enter on Form 1041, line 3.

• If you checked 32b, you must attach Form 6198. Your loss may be limited.

} 32a All investment is at risk.

32b Some investment is not

at risk.

For Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 11334P Schedule C (Form 1040) 2013

-5942

0

LONG BEACH

✔

494

0

0

0

0

CA

948

0

0

90805

0

1235

-5942

9 9 9 9 9 9

✔

ALEJANDRO GARIBAY

0

SALES

615-88-8657

0

777

0

0

5942

0

0

0

0

0

✔

0

0

0

0

0

7143 MYRTLE AVENUE

24880

Schedule C (Form 1040) 2013 Page 2

Part III Cost of Goods Sold (see instructions)

33

Method(s) used to

value closing inventory: a Cost b Lower of cost or market c Other (attach explanation)

34

Was there any change in determining quantities, costs, or valuations between opening and closing inventory?

If “Yes,” attach explanation . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

35 Inventory at beginning of year. If different from last year’s closing inventory, attach explanation . . . 35

36 Purchases less cost of items withdrawn for personal use . . . . . . . . . . . . . . 36

37 Cost of labor. Do not include any amounts paid to yourself . . . . . . . . . . . . . . 37

38 Materials and supplies . . . . . . . . . . . . . . . . . . . . . . . . 38

39 Other costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

40 Add lines 35 through 39 . . . . . . . . . . . . . . . . . . . . . . . . 40

41 Inventory at end of year . . . . . . . . . . . . . . . . . . . . . . . . 41

42 Cost of goods sold. Subtract line 41 from line 40. Enter the result here and on line 4 . . . . . . 42

Part IV Information on Your Vehicle. Complete this part only if you are claiming car or truck expenses on line 9 and are not required to file Form 4562 for this business. See the instructions for line 13 to find out if you must file Form 4562.

43 When did you place your vehicle in service for business purposes? (month, day, year) ▶ / /

44 Of the total number of miles you drove your vehicle during 2013, enter the number of miles you used your vehicle for:

a Business b Commuting (see instructions) c Other

45 Was your vehicle available for personal use during off-duty hours? . . . . . . . . . . . . . . . Yes No

46 Do you (or your spouse) have another vehicle available for personal use?. . . . . . . . . . . . . . Yes No

47a Do you have evidence to support your deduction? . . . . . . . . . . . . . . . . . . . . Yes No

b If “Yes,” is the evidence written? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

Part V Other Expenses. List below business expenses not included on lines 8–26 or line 30.

48 Total other expenses. Enter here and on line 27a . . . . . . . . . . . . . . . . 48

Schedule C (Form 1040) 2013

0

0

2488PRODUCTS

0

0

2488

0

0

0

0

SCHEDULE A (Form 1040)

Department of the Treasury Internal Revenue Service (99)

Itemized Deductions▶ Information about Schedule A and its separate instructions is at www.irs.gov/schedulea.

▶ Attach to Form 1040.

OMB No. 1545-0074

2013Attachment Sequence No. 07

Name(s) shown on Form 1040 Your social security number

Medical and Dental Expenses

Caution. Do not include expenses reimbursed or paid by others. 1 Medical and dental expenses (see instructions) . . . . . 1 2 Enter amount from Form 1040, line 38 2 3 Multiply line 2 by 10% (.10). But if either you or your spouse was

born before January 2, 1949, multiply line 2 by 7.5% (.075) instead 3 4 Subtract line 3 from line 1. If line 3 is more than line 1, enter -0- . . . . . . . . 4

Taxes You Paid

5 State and local (check only one box):a Income taxes, orb General sales taxes } . . . . . . . . . . . 5

6 Real estate taxes (see instructions) . . . . . . . . . 6 7 Personal property taxes . . . . . . . . . . . . . 7 8 Other taxes. List type and amount ▶

8 9 Add lines 5 through 8 . . . . . . . . . . . . . . . . . . . . . . 9

Interest You Paid

Note. Your mortgage interest deduction may be limited (see instructions).

10 Home mortgage interest and points reported to you on Form 1098 10 11

Home mortgage interest not reported to you on Form 1098. If paid to the person from whom you bought the home, see instructions and show that person’s name, identifying no., and address ▶

11 12

Points not reported to you on Form 1098. See instructions for special rules . . . . . . . . . . . . . . . . . 12

13 Mortgage insurance premiums (see instructions) . . . . . 13 14 Investment interest. Attach Form 4952 if required. (See instructions.) 14 15 Add lines 10 through 14 . . . . . . . . . . . . . . . . . . . . . 15

Gifts to CharityIf you made a gift and got a benefit for it, see instructions.

16

Gifts by cash or check. If you made any gift of $250 or more, see instructions . . . . . . . . . . . . . . . . 16

17

Other than by cash or check. If any gift of $250 or more, see instructions. You must attach Form 8283 if over $500 . . . 17

18 Carryover from prior year . . . . . . . . . . . . 1819 Add lines 16 through 18 . . . . . . . . . . . . . . . . . . . . . 19

Casualty and Theft Losses 20 Casualty or theft loss(es). Attach Form 4684. (See instructions.) . . . . . . . . 20 Job Expenses and Certain Miscellaneous Deductions

21

Unreimbursed employee expenses—job travel, union dues, job education, etc. Attach Form 2106 or 2106-EZ if required. (See instructions.) ▶ 21

22 Tax preparation fees . . . . . . . . . . . . . 22 23

Other expenses—investment, safe deposit box, etc. List type and amount ▶

23 24 Add lines 21 through 23 . . . . . . . . . . . . 24 25 Enter amount from Form 1040, line 38 25 26 Multiply line 25 by 2% (.02) . . . . . . . . . . . 26 27 Subtract line 26 from line 24. If line 26 is more than line 24, enter -0- . . . . . . 27

Other Miscellaneous Deductions

28 Other—from list in instructions. List type and amount ▶

28 Total Itemized Deductions

29

Is Form 1040, line 38, over $150,000?

29 No. Your deduction is not limited. Add the amounts in the far right column for lines 4 through 28. Also, enter this amount on Form 1040, line 40. } . .Yes. Your deduction may be limited. See the Itemized Deductions Worksheet in the instructions to figure the amount to enter.

30

If you elect to itemize deductions even though they are less than your standard deduction, check here . . . . . . . . . . . . . . . . . . . ▶

For Paperwork Reduction Act Notice, see Form 1040 instructions. Cat. No. 17145C Schedule A (Form 1040) 2013

450

3861

0

0

25181

6871

615-88-8657

5285

LEGAL EXPENSES

0

1448

335

0

0

2637

0

See STATEMENT Other Deductible

5285

2378

5882

1329

959

0

66442

0

9249

✔

0

5739

ALEJANDRO, GARIBAY

265

6332

7068

0

Form 2106 Department of the Treasury Internal Revenue Service (99)

Employee Business Expenses Attach to Form 1040 or Form 1040NR.

Information about Form 2106 and its separate instructions is available at www.irs.gov/form2106.

OMB No. 1545-0074

2012 Attachment Sequence No. 129

Your name Occupation in which you incurred expenses Social security number

Part I Employee Business Expenses and Reimbursements

Step 1 Enter Your Expenses

Column A

Other Than Meals and Entertainment

Column B

Meals and Entertainment

1 Vehicle expense from line 22 or line 29. (Rural mail carriers: See instructions.) . . . . . . . . . . . . . . . . . . 1

2 Parking fees, tolls, and transportation, including train, bus, etc., that did not involve overnight travel or commuting to and from work . 2

3 Travel expense while away from home overnight, including lodging, airplane, car rental, etc. Do not include meals and entertainment . 3

4 Business expenses not included on lines 1 through 3. Do not include meals and entertainment . . . . . . . . . . . . . . 4

5 Meals and entertainment expenses (see instructions) . . . . . 5

6 Total expenses. In Column A, add lines 1 through 4 and enter the result. In Column B, enter the amount from line 5 . . . . . . 6

Note: If you were not reimbursed for any expenses in Step 1, skip line 7 and enter the amount from line 6 on line 8.

Step 2 Enter Reimbursements Received From Your Employer for Expenses Listed in Step 1

7

Enter reimbursements received from your employer that were not reported to you in box 1 of Form W-2. Include any reimbursements reported under code “L” in box 12 of your Form W-2 (see instructions) . . . . . . . . . . . . . . . . . . . 7

Step 3 Figure Expenses To Deduct on Schedule A (Form 1040 or Form 1040NR)

8

Subtract line 7 from line 6. If zero or less, enter -0-. However, if line 7 is greater than line 6 in Column A, report the excess as income on Form 1040, line 7 (or on Form 1040NR, line 8) . . . . . . . 8

Note: If both columns of line 8 are zero, you cannot deduct employee business expenses. Stop here and attach Form 2106 to your return.

9

In Column A, enter the amount from line 8. In Column B, multiply line 8 by 50% (.50). (Employees subject to Department of Transportation (DOT) hours of service limits: Multiply meal expenses incurred while away from home on business by 80% (.80) instead of 50%. For details, see instructions.) . . . . . . . . . . . . . . 9

10

Add the amounts on line 9 of both columns and enter the total here. Also, enter the total on

Schedule A (Form 1040), line 21 (or on Schedule A (Form 1040NR), line 7). (Armed Forces reservists, qualified performing artists, fee-basis state or local government officials, and individuals with disabilities: See the instructions for special rules on where to enter the total.) . . . . . 10

For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 11700N Form 2106 (2012)

0

0

1448

1448

0

0

ALEJANDRO GARIBAY

1448

1448

1448

PROJECT MANAGER 6 1 5 8 8 8 6 5 7

Form 2106 (2012) Page 2

Part II Vehicle Expenses

Section A—General Information (You must complete this section if you are claiming vehicle expenses.)

(a) Vehicle 1 (b) Vehicle 2

11 Enter the date the vehicle was placed in service . . . . . . . . . 11 / / / / 12 Total miles the vehicle was driven during 2012 . . . . . . . . . 12 miles miles 13 Business miles included on line 12 . . . . . . . . . . . . . 13 miles miles 14 Percent of business use. Divide line 13 by line 12 . . . . . . . . . 14 % % 15 Average daily roundtrip commuting distance . . . . . . . . . . 15 miles miles 16 Commuting miles included on line 12 . . . . . . . . . . . . 16 miles miles 17 Other miles. Add lines 13 and 16 and subtract the total from line 12 . . 17 miles miles 18 Was your vehicle available for personal use during off-duty hours? . . . . . . . . . . . . . Yes No

19 Do you (or your spouse) have another vehicle available for personal use? . . . . . . . . . . . Yes No

20 Do you have evidence to support your deduction? . . . . . . . . . . . . . . . . . . Yes No

21 If “Yes,” is the evidence written? . . . . . . . . . . . . . . . . . . . . . . . . Yes No

Section B—Standard Mileage Rate (See the instructions for Part II to find out whether to complete this section or Section C.) 22 Multiply line 13 by 55.5¢ (.555). Enter the result here and on line 1 . . . . . . . . . . 22

Section C—Actual Expenses (a) Vehicle 1 (b) Vehicle 2 23 Gasoline, oil, repairs, vehicle

insurance, etc. . . . . . . 23

24a Vehicle rentals . . . . . . 24a

b Inclusion amount (see instructions) . 24b

c Subtract line 24b from line 24a . 24c

25 Value of employer-provided vehicle (applies only if 100% of annual lease value was included on Form W-2—see instructions) . . . .

25

26 Add lines 23, 24c, and 25. . . 26

27 Multiply line 26 by the percentage on line 14 . . . . . . . . 27

28 Depreciation (see instructions) . 28

29 Add lines 27 and 28. Enter total here and on line 1 . . . . . 29

Section D—Depreciation of Vehicles (Use this section only if you owned the vehicle and are completing Section C for the vehicle.) (a) Vehicle 1 (b) Vehicle 2

30 Enter cost or other basis (see instructions) . . . . . . . 30

31 Enter section 179 deduction and special allowance (see instructions) 31

32 Multiply line 30 by line 14 (see instructions if you claimed the section 179 deduction or special allowance). . . . . . . . 32

33 Enter depreciation method and percentage (see instructions) . 33

34 Multiply line 32 by the percentage on line 33 (see instructions) . . 34

35 Add lines 31 and 34 . . . . 35

36 Enter the applicable limit explained in the line 36 instructions . . . 36

37 Multiply line 36 by the percentage on line 14 . . . . . . . . 37

38 Enter the smaller of line 35 or line 37. If you skipped lines 36 and 37, enter the amount from line 35. Also enter this amount on line 28 above . . . . . . . . .

38

Form 2106 (2012)

0

0

0

0

0.00

0

0

0

0

0

0

0

0.00

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

Form 8863Department of the Treasury Internal Revenue Service (99)

Education Credits (American Opportunity and Lifetime Learning Credits)

▶ Information about Form 8863 and its separate instructions is at www.irs.gov/form8863. ▶ Attach to Form 1040 or Form 1040A.

OMB No. 1545-0074

2013Attachment Sequence No. 50

Name(s) shown on return Your social security number

▲!CAUTION

Complete a separate Part III on page 2 for each student for whom you are claiming either credit before you complete Parts I and II.

Part I Refundable American Opportunity Credit 1 After completing Part III for each student, enter the total of all amounts from all Parts III, line 30 . 12 Enter: $180,000 if married filing jointly; $90,000 if single, head of household, or

qualifying widow(er) . . . . . . . . . . . . . . . . . . 2

3 Enter the amount from Form 1040, line 38, or Form 1040A, line 22. If you are filing Form 2555, 2555-EZ, or 4563, or you are excluding income from Puerto Rico, see Pub. 970 for the amount to enter . . . . . . . . . . . . 3

4 Subtract line 3 from line 2. If zero or less, stop; you cannot take any education credit . . . . . . . . . . . . . . . . . . . . 4

5 Enter: $20,000 if married filing jointly; $10,000 if single, head of household, or qualifying widow(er) . . . . . . . . . . . . . . . . . . 5

6 If line 4 is: • Equal to or more than line 5, enter 1.000 on line 6 . . . . . . . . . . . . .• Less than line 5, divide line 4 by line 5. Enter the result as a decimal (rounded to at

least three places) . . . . . . . . . . . . . . . . . . . . . . .} . . . . 6 .

7 Multiply line 1 by line 6. Caution: If you were under age 24 at the end of the year and meet the conditions described in the instructions, you cannot take the refundable American opportunity credit; skip line 8, enter the amount from line 7 on line 9, and check this box . . . . . . ▶ 7

8 Refundable American opportunity credit. Multiply line 7 by 40% (.40). Enter the amount here and on Form 1040, line 66, or Form 1040A, line 40. Then go to line 9 below . . . . . . . . . . . . 8

Part II Nonrefundable Education Credits9 Subtract line 8 from line 7. Enter here and on line 2 of the Credit Limit Worksheet (see instructions) . . 9

10 After completing Part III for each student, enter the total of all amounts from all Parts III, line 31. If zero, skip lines 11 through 17, enter -0- on line 18, and go to line 19 . . . . . . . . . . . . . . . 10

11 Enter the smaller of line 10 or $10,000 . . . . . . . . . . . . . . . . . . . . . 1112 Multiply line 11 by 20% (.20) . . . . . . . . . . . . . . . . . . . . . . . . 1213 Enter: $127,000 if married filing jointly; $63,000 if single, head of household, or

qualifying widow(er) . . . . . . . . . . . . . . . . . . 13

14 Enter the amount from Form 1040, line 38, or Form 1040A, line 22. If you are filing Form 2555, 2555-EZ, or 4563, or you are excluding income from Puerto Rico, see Pub. 970 for the amount to enter . . . . . . . . . . . . 14

15 Subtract line 14 from line 13. If zero or less, skip lines 16 and 17, enter -0- on line 18, and go to line 19 . . . . . . . . . . . . . . . . . . 15

16 Enter: $20,000 if married filing jointly; $10,000 if single, head of household, or qualifying widow(er) . . . . . . . . . . . . . . . . . . 16

17 If line 15 is: • Equal to or more than line 16, enter 1.000 on line 17 and go to line 18

• Less than line 16, divide line 15 by line 16. Enter the result as a decimal (rounded to at least three places) 17 .18 Multiply line 12 by line 17. Enter here and on line 1 of the Credit Limit Worksheet (see instructions) . . . ▶ 1819 Nonrefundable education credits. Enter the amount from line 7 of the Credit Limit Worksheet (see

instructions) here and on Form 1040, line 49, or Form 1040A, line 31 . . . . . . . . . . . . 19For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 25379M Form 8863 (2013)

23558

0

1000020456

66442

2000

ALEJANDROGARIBAY 8657

0

615

0

10000

88

0.0

0

1.0

63000

10000

66442

0

0

0

90000

Form 8863 (2013) Page 2 Name(s) shown on return Your social security number

▲!CAUTION

Complete Part III for each student for whom you are claiming either the American opportunity credit or lifetime learning credit. Use additional copies of Page 2 as needed for each student.

Part III Student and Educational Institution Information See instructions.

20 Student name (as shown on page 1 of your tax return) 21 Student social security number (as shown on page 1 of your tax return)

22 Educational institution information (see instructions)a. Name of first educational institution

(1) Address. Number and street (or P.O. box). City, town or post office, state, and ZIP code. If a foreign address, see instructions.

(2) Did the student receive Form 1098-T from this institution for 2013?

Yes No

(3) Did the student receive Form 1098-T from this institution for 2012 with Box 2 filled in and Box 7 checked?

Yes No

If you checked “No” in both (2) and (3), skip (4).(4) If you checked “Yes” in (2) or (3), enter the institution's

federal identification number (from Form 1098-T).–

b. Name of second educational institution (if any)

(1) Address. Number and street (or P.O. box). City, town or post office, state, and ZIP code. If a foreign address, see instructions.

(2) Did the student receive Form 1098-T from this institution for 2013?

Yes No

(3) Did the student receive Form 1098-T from this institution for 2012 with Box 2 filled in and Box 7 checked?

Yes No

If you checked “No” in both (2) and (3), skip (4).(4) If you checked “Yes” in (2) or (3), enter the institution's

federal identification number (from Form 1098-T).–

23 Has the Hope Scholarship Credit or American opportunity credit been claimed for this student for any 4 tax years before 2013?

Yes — Stop! Go to line 31 for this student. No — Go to line 24.

24 Was the student enrolled at least half-time for at least one academic period that began in 2013 at an eligible educational institution in a program leading towards a postsecondary degree, certificate, or other recognized postsecondary educational credential? (see instructions)

Yes — Go to line 25. No — Stop! Go to line 31 for this student.

25 Did the student complete the first 4 years of post-secondary education before 2013?

Yes — Stop! Go to line 31 for this student.

No — Go to line 26.

26 Was the student convicted, before the end of 2013, of a felony for possession or distribution of a controlled substance?

Yes — Stop! Go to line 31 for this student.

No — See Tip below and complete either lines 27-30 or line 31 for this student.

TIPWhen you figure your taxes, you may want to compare the American opportunity credit and lifetime learning credits, and choose the credit for each student that gives you the lower tax liability. You cannot take the American opportunity credit and the lifetime learning credit for the same student in the same year. If you complete lines 27 through 30 for this student, do not complete line 31.

American Opportunity Credit 27 Adjusted qualified education expenses (see instructions). Do not enter more than $4,000 . . . . 2728 Subtract $2,000 from line 27. If zero or less enter -0- . . . . . . . . . . . . . . . . . 2829 Multiply line 28 by 25% (.25) . . . . . . . . . . . . . . . . . . . . . . . . . 2930 If line 28 is zero, enter the amount from line 27. Otherwise, add $2,000 to the amount on line 29 and

enter the result. Skip line 31. Include the total of all amounts from all Parts III, line 30 on Part I, line 1 . 30Lifetime Learning Credit

31 Adjusted qualified education expenses (see instructions). Include the total of all amounts from all Parts III, line 31, on Part II, line 10 . . . . . . . . . . . . . . . . . . . . . . . . . 31

Form 8863 (2013)

0

✔

85040

6 1 5 8 8 8 6 5 7

✔

0

ALEJANDRO

PHOENIX

20456

✔

0

4025 SOUTH RIVERPOINT PARKWAY

9 4 2 4 7 3 2 1 0

AZ

UNIVERSITY OF PHOENIX

0

ALEJANDRO GARIBAY

6 1 5 - 8 8 - 8 6 5 7

Form 2441Department of the Treasury Internal Revenue Service (99)

Child and Dependent Care Expenses▶ Attach to Form 1040, Form 1040A, or Form 1040NR.

▶ Information about Form 2441 and its separate instructions is at www.irs.gov/form2441.

1040A . . . . . . . . . . 1040

2441

◀. . . . . . . . . .

1040NR

OMB No. 1545-0074

2013Attachment Sequence No. 21

Name(s) shown on return Your social security number

Part I Persons or Organizations Who Provided the Care—You must complete this part. (If you have more than two care providers, see the instructions.)

1 (a) Care provider’s name

(b) Address (number, street, apt. no., city, state, and ZIP code)

(c) Identifying number (SSN or EIN)

(d) Amount paid (see instructions)

Did you receive dependent care benefits?

No ▶ Complete only Part II below.Yes ▶ Complete Part III on the back next.

Caution. If the care was provided in your home, you may owe employment taxes. If you do, you cannot file Form 1040A. For details, see the instructions for Form 1040, line 59a, or Form 1040NR, line 58a.

Part II Credit for Child and Dependent Care Expenses2 Information about your qualifying person(s). If you have more than two qualifying persons, see the instructions.

(a) Qualifying person’s name

First Last

(b) Qualifying person’s social security number

(c) Qualified expenses you incurred and paid in 2013 for the

person listed in column (a)

3

Add the amounts in column (c) of line 2. Do not enter more than $3,000 for one qualifying person or $6,000 for two or more persons. If you completed Part III, enter the amount from line 31 . . . . . . . . . . . . . . . . . . . . . . . . . . 3

4 Enter your earned income. See instructions . . . . . . . . . . . . . . . 4 5 If married filing jointly, enter your spouse’s earned income (if you or your spouse was a

student or was disabled, see the instructions); all others, enter the amount from line 4 . 5 6 Enter the smallest of line 3, 4, or 5 . . . . . . . . . . . . . . . . . . 6 7 Enter the amount from Form 1040, line 38; Form

1040A, line 22; or Form 1040NR, line 37. . . . . 7 8 Enter on line 8 the decimal amount shown below that applies to the amount on line 7

If line 7 is:

OverBut not over

Decimal amount is

$0—15,000 .35

15,000—17,000 .34

17,000—19,000 .33

19,000—21,000 .32

21,000—23,000 .31

23,000—25,000 .30

25,000—27,000 .29

27,000—29,000 .28

If line 7 is:

OverBut not over

Decimal amount is

$29,000—31,000 .27

31,000—33,000 .26

33,000—35,000 .25

35,000—37,000 .24

37,000—39,000 .23

39,000—41,000 .22

41,000—43,000 .21

43,000—No limit .20

8 X .

9 Multiply line 6 by the decimal amount on line 8. If you paid 2012 expenses in 2013, see the instructions . . . . . . . . . . . . . . . . . . . . . . . . . 9

10 Tax liability limit. Enter the amount from the Credit Limit Worksheet in the instructions. . . . . . . 10

11 Credit for child and dependent care expenses. Enter the smaller of line 9 or line 10 here and on Form 1040, line 48; Form 1040A, line 29; or Form 1040NR, line 46 . . . . 11

For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 11862M Form 2441 (2013)

3000

ALEJANDROGARIBAY

0.2

90002

66219

558-93-4704

3000

66442

621-83-5995ITZIA GUADALUPE

600

CA

66219

600

ROSIE M, FUENTES LOS ANGELES

3000

30009536 GRAHAM AVENUE

615-88-8657

3799

PEREZ

Form 2441 (2013) Page 2Part III Dependent Care Benefits12

Enter the total amount of dependent care benefits you received in 2013. Amounts youreceived as an employee should be shown in box 10 of your Form(s) W-2. Do not includeamounts reported as wages in box 1 of Form(s) W-2. If you were self-employed or a partner, include amounts you received under a dependent care assistance program fromyour sole proprietorship or partnership . . . . . . . . . . . . . . . . . . 12

13 Enter the amount, if any, you carried over from 2012 and used in 2013 during the grace period. See instructions . . . . . . . . . . . . . . . . . . . . . . . 13

14 Enter the amount, if any, you forfeited or carried forward to 2014. See instructions . . . 14 ( )15 Combine lines 12 through 14. See instructions . . . . . . . . . . . . . . . 15 16 Enter the total amount of qualified expenses incurred

in 2013 for the care of the qualifying person(s) . . . 16 17 Enter the smaller of line 15 or 16 . . . . . . . . 17 18 Enter your earned income. See instructions . . . . 18 19 Enter the amount shown below that applies

to you.

• If married filing jointly, enter your spouse’s earned income (if you or your spouse was a student or was disabled, see the instructions for line 5).

• If married filing separately, see instructions.

• All others, enter the amount from line 18.

} . . . 19

20 Enter the smallest of line 17, 18, or 19 . . . . . . 20 21

Enter $5,000 ($2,500 if married filing separately and you were required to enter your spouse’s earned income on line 19) . . . . . . . . . . . . . 21

22 Is any amount on line 12 from your sole proprietorship or partnership? (Form 1040A filers go to line 25.)

No. Enter -0-.Yes. Enter the amount here . . . . . . . . . . . . . . . . . . . . 22

23 Subtract line 22 from line 15 . . . . . . . . . 23 24 Deductible benefits. Enter the smallest of line 20, 21, or 22. Also, include this amount on

the appropriate line(s) of your return. See instructions . . . . . . . . . . . . . 24 25

Excluded benefits. Form 1040 and 1040NR filers: If you checked "No" on line 22, enter the smaller of line 20 or 21. Otherwise, subtract line 24 from the smaller of line 20 or line21. If zero or less, enter -0-. Form 1040A filers: Enter the smaller of line 20 or line 21 . . 25

26

Taxable benefits. Form 1040 and 1040NR filers: Subtract line 25 from line 23. If zero or less, enter -0-. Also, include this amount on Form 1040, line 7, or Form 1040NR, line 8. Onthe dotted line next to Form 1040, line 7, or Form 1040NR, line 8, enter “DCB.”Form 1040A filers: Subtract line 25 from line 15. Also, include this amount on Form 1040A, line 7. In the space to the left of line 7, enter “DCB” . . . . . . . . . . . . . . 26

To claim the child and dependent care credit, complete lines 27 through 31 below.

27 Enter $3,000 ($6,000 if two or more qualifying persons) . . . . . . . . . . . . 27 28 Form 1040 and 1040NR filers: Add lines 24 and 25. Form 1040A filers: Enter the amount

from line 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 29

Subtract line 28 from line 27. If zero or less, stop. You cannot take the credit. Exception. If you paid 2012 expenses in 2013, see the instructions for line 9 . . . . . 29

30 Complete line 2 on the front of this form. Do not include in column (c) any benefits shown on line 28 above. Then, add the amounts in column (c) and enter the total here. . . . . 30

31 Enter the smaller of line 29 or 30. Also, enter this amount on line 3 on the front of this formand complete lines 4 through 11 . . . . . . . . . . . . . . . . . . . . 31

Form 2441 (2013)

3000

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3000

3000

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3000

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Form 8879Department of the Treasury Internal Revenue Service

IRS e-file Signature Authorization▶ Do not send to the IRS. This is not a tax return.

▶ Keep this form for your records.

▶ Information about Form 8879 and its instructions is at www.irs.gov/form8879.

OMB No. 1545-0074

2013

Submission Identification Number (SID)

▲

Taxpayer’s name Social security number

Spouse’s name Spouse’s social security number

Part I Tax Return Information—Tax Year Ending December 31, 2013 (Whole Dollars Only)1 Adjusted gross income (Form 1040, line 38; Form 1040A, line 22; Form 1040EZ, line 4) . . . . . . . . 12 Total tax (Form 1040, line 61; Form 1040A, line 35; Form 1040EZ, line 10) . . . . . . . . . . . . 23 Federal income tax withheld (Form 1040, line 62; Form 1040A, line 36; Form 1040EZ, line 7) . . . . . . 34 Refund (Form 1040, line 74a; Form 1040A, line 43a; Form 1040EZ, line 11a; Form 1040-SS, Part I, line 13a) 45 Amount you owe (Form 1040, line 76; Form 1040A, line 45; Form 1040EZ, line 12) . . . . . . . . . 5

Part II Taxpayer Declaration and Signature Authorization (Be sure you get and keep a copy of your return)

Under penalties of perjury, I declare that I have examined a copy of my electronic individual income tax return and accompanying schedules and statements for the tax year ending December 31, 2013, and to the best of my knowledge and belief, it is true, correct, and complete. I further declare that the amounts in Part I above are the amounts from my electronic income tax return. I consent to allow my intermediate service provider, transmitter, or electronic return originator (ERO) to send my return to the IRS and to receive from the IRS (a) an acknowledgement of receipt or reason for rejection of the transmission, (b) the reason for any delay in processing the return or refund, and (c) the date of any refund. If applicable, I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the financial institution account indicated in the tax preparation software for payment of my federal taxes owed on this return and/or a payment of estimated tax, and the financial institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke (cancel) a payment, I must contact the U.S. Treasury Financial Agent at 1-888-353-4537. Payment cancellation requests must be received no later than 2 business days prior to the payment (settlement) date. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payment. I further acknowledge that the personal identification number (PIN) below is my signature for my electronic income tax return and, if applicable, my Electronic Funds Withdrawal Consent.

Taxpayer’s PIN: check one box onlyI authorize

ERO firm nameto enter or generate my PIN

Enter five numbers, but do not enter all zerosas my signature on my tax year 2013 electronically filed income tax return.

I will enter my PIN as my signature on my tax year 2013 electronically filed income tax return. Check this box only if you are entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III below.

Your signature ▶ Date ▶

Spouse’s PIN: check one box onlyI authorize

ERO firm nameto enter or generate my PIN

Enter five numbers, but do not enter all zerosas my signature on my tax year 2013 electronically filed income tax return.

I will enter my PIN as my signature on my tax year 2013 electronically filed income tax return. Check this box only if you are entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III below.

Spouse’s signature ▶ Date ▶

Practitioner PIN Method Returns Only—continue belowPart III Certification and Authentication—Practitioner PIN Method Only

ERO’s EFIN/PIN. Enter your six-digit EFIN followed by your five-digit self-selected PIN.Do not enter all zeros

I certify that the above numeric entry is my PIN, which is my signature for the tax year 2013 electronically filed income tax return for the taxpayer(s) indicated above. I confirm that I am submitting this return in accordance with the requirements of the Practitioner PIN method and Publication 1345, Handbook for Authorized IRS e-file Providers of Individual Income Tax Returns.

ERO’s signature ▶ Date ▶

ERO Must Retain This Form — See Instructions Do Not Submit This Form to the IRS Unless Requested To Do So

For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 32778X Form 8879 (2013)

9 6 7 3 6 4 1 7 2 4 2

0

ALEJANDRO GARIBAY

✔ ZEVCO

664421199

1 7 5 6 8

615-88-8657

1990791

State For State Purpose Only

State Income - Adjustments Allocation Worksheet

None Resident WorksheetNon Resident State: Non Resident State:

Description Tax Payer/

Default

Spouse Taxpayer/

Default

Spouse

1. Wages…………………………

2. Excess received for business

expense, moving expense and

child care expense……………

3. Disability Income……………

4. Household employee income…

5. Allocation Tips………………

6. Dependent Care benefits………

7. Taxable interest income……….

8. Alimony received……………

9. Ordinary dividends……………

10. Taxable refunds, credits or

offsets of states and local

income taxes…………………..

11. Business income or (loss)……..

12. Capital gain or (loss)………….

13. Other Gains……………………

14. Pensions and annuities………...

15. Taxable IRA amt……………...

16. Rental real estate, royalties,

partnership, trust, etc………….

17. Farm income…………………..

18. Social security(taxable amount)

19. Unemployment Compensation..

20. Other Income………………….

Total Income…………………….

Adjustments to income21. Educator expense……………...

22. Certain business expense of

reservists, performing artist,

fee basis government officials..

23. Health savings account

deduction

24. Moving expenses……………..

25. One Half of Self Employment

taxes…………………………..

26. Self employed SEP, Simple,

and qualified plans……………

27. Self employed health insurance

deduction……………………

28. Penalty on early withdrawal….

29. Alimony paid…………………

30. IRA Deduction………………..

31. Student loan interest deduction

32. Student Tution fees deduction..

33. Domestic production activities

deduction……………………..

34. Other adjustments “Type here

and Enter here………………...

35. Total Adjustments……………

36. Adjusted Gross Income………

37. Taxable Income…………………………………………………………

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3101133

For Privacy Notice, get FTB 1131 ENG/SP.

California Resident Income Tax Return 2013FORM

540 C1 Side 1Fiscal year filers only: Enter month of year end: month________ year 2014.

A

R

RP

Your first name Initial Last name Your SSN or ITIN

If joint tax return, spouse's/RDP's first name Initial Last name Spouse's/RDP's SSN or ITIN

Additional information (See instructions) PBA Code

Street address (Number and street or PO Box) Apt. no/Ste. no. PMB/Private Mailbox

City (If you have a foreign address, see instructions) State ZIP Code

Foreign Country Name Foreign Province/State/County Foreign Postal Code

Dat

e of

Bir

th

Your DOB (mm/dd/yyyy) Spouse's/RDP's DOB (mm/dd/yyyy)

Pri

or

Nam

e

If you filed your 2012 tax return under a different last name, write the last name only from the 2012 tax return. Taxpayer Spouse/RDP

Fili

ng

Sta

tus

1 Single 4 Head of household (with qualifying person). See instructions.

2 Married/RDP filing jointly. See inst. 5 Qualifying widow(er) with dependent child. Enter year spouse/RDP died

3 Married/RDP filing separately. Enter spouse’s/RDP’s SSN or ITIN above and full name here

If your California filing status is different from your federal filing status, check the box here . . . . . . . . . .

6 If someone can claim you (or your spouse/RDP) as a dependent, check the box here. See inst.. . . . . . . .  6

Exe

mp

tio

ns

For line 7, line 8, line 9, and line 10: Multiply the amount 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 box 2 or 5, enter 2, in the box. If you checked the box on line 6, see instructions. . . . 7 X $106 = $

8 Blind: If you (or your spouse/RDP) are visually impaired, enter 1; if both are visually impaired, enter 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 X $106 = $

9 Senior: If you (or your spouse/RDP) are 65 or older, enter 1; if both are 65 or older, enter 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 X $106 = $

10 Dependents: Do not include yourself or your spouse/RDP.

First name Last name Dependent's relationship to you

Total dependent exemptions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 X $326 = $

11 Exemption amount: Add line 7 through line 10. Transfer this amount to line 32 . . . . . . . . . . . . . . . . . . . 11 $

EFILE ONLY DO NOT PAPER FILE.

1

✔

0 2 1 8 1 9 8 1

ITZIA GUADALUPE

758

0

7143 MYRTLE AVENUE

0

652

LONG BEACH

NIECE

2

6 1 5 8 8 8 6 5 7

PEREZ

ALEJANDRO

0

9 0 8 0 5

AVALOS AVILA

✔

CA

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VANESSA

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GARIBAY

NIECE

106

Side 2 Form 540 C1 2013 3102133

12 State wages from your Form(s) W-2, box 16 . . . . . . . . . . . . . . . . . . . . . . . 12

13 Enter federal adjusted gross income from Form 1040, line 37; 1040A, line 21; or 1040EZ, line 4 . . . . . . 13

14 California adjustments – subtractions. Enter the amount from Schedule CA (540), line 37, column B . . 14

15 Subtract line 14 from line 13. If less than zero, enter the result in parentheses. See instructions . . . . . . . . . 15

16 California adjustments – additions. Enter the amount from Schedule CA (540), line 37, column C . . . . . 16

17 California adjusted gross income. Combine line 15 and line 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1718 Enter the Your California itemized deductions from Schedule CA (540), line 44; OR larger of: Your California standard deduction shown below for your filing status: • Single or Married/RDP filing separately. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$3,906 • Married/RDP filing jointly, Head of household, or Qualifying widow(er) . . . . .$7,812 If the box on line 6 is checked, STOP. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

19 Subtract line 18 from line 17. This is your taxable income. If less than zero, enter -0-. . . . . . . . . . . . . . 19

Taxa

ble

Inco

me

{ {

Tax

31 Tax. Check the box if from: Tax Table Tax Rate Schedule

FTB 3800 FTB 3803. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

32 Exemption credits. Enter the amount from line 11. If your federal AGI is more than $172,615, see instructions.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

33 Subtract line 32 from line 31. If less than zero, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

34 Tax. See instructions. Check the box if from:   Schedule G-1   FTB 5870A. . . . . . . . . 34

35 Add line 33 and line 34. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

Sp

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40 Nonrefundable Child and Dependent Care Expenses Credit. See instructions. . . . . . . . . . . . . . . . . . . . . . . 40

41 New jobs credit, amount generated. See instructions . . . . . . . . . . . . . . . . 41

42 New jobs credit, amount claimed. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

43 Enter credit name code and amount . . . 43

44 Enter credit name code and amount . . . 44

45 To claim more than two credits, see instructions. Attach Schedule P (540). . . . . . . . . . . . . . . . . . . . . . . . 45

46 Nonrefundable renter’s credit. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

47 Add line 40 and line 42 through line 46. These are your total credits. . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

48 Subtract line 47 from line 35. If less than zero, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

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Your name: Your SSN or ITIN:

EFILE ONLY DO NOT PAPER FILE.

66442

0

72161

0

✔

66249

758

✔

0

193

821

0

63

66249

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6 1 5 8 8 8 6 5 7

63

42292

0

ALEJANDRO

23957

0

0

Form 540 C1 2013 Side 33103133

Oth

er T

axes

61 Alternative minimum tax. Attach Schedule P (540) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

62 Mental Health Services Tax. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

63 Other taxes and credit recapture. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

64 Add line 48, line 61, line 62, and line 63. This is your total tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

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71 California income tax withheld. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

72 2013 CA estimated tax and other payments. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72

73 Real estate and other withholding. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

74 Excess SDI (or VPDI) withheld. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74

75 Add line 71, line 72, line 73, and line 74. These are your total payments. See instructions . . . . . . . . . . . 75

Ove

rpai

d T

ax/

Tax

Du

e

91 Overpaid tax. If line 75 is more than line 64, subtract line 64 from line 75. . . . . . . . . . . . . . . . . . . . . . . . 91

92 Amount of line 91 you want applied to your 2014 estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92

93 Overpaid tax available this year. Subtract line 92 from line 91 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93

94 Tax due. If line 75 is less than line 64, subtract line 75 from line 64. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94

Your name: Your SSN or ITIN:

This space reserved for 2D barcode

This space reserved for 2D barcode

EFILE ONLY DO NOT PAPER FILE.

959

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ALEJANDRO 6 1 5 8 8 8 6 5 7

0

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63

Side 4 Form 540 C1 2013 3104133

Use

Ta

x

95 Use Tax. This is not a total line. See instructions . . . . . . . . . . . . . . . . . . . 95

Co

ntr

ibu

tio

ns

Code Amount

California Seniors Special Fund. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 400

Alzheimer’s Disease/Related Disorders Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 401

California Fund for Senior Citizens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 402

Rare and Endangered Species Preservation Program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 403

State Children’s Trust Fund for the Prevention of Child Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 404

California Breast Cancer Research Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 405

California Firefighters’ Memorial Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 406

Emergency Food for Families Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 407

California Peace Officer Memorial Foundation Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 408

California Sea Otter Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 410

Municipal Shelter Spay-Neuter Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 412

California Cancer Research Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 413

Child Victims of Human Trafficking Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 419

California YMCA Youth and Government Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 420

California Youth Leadership Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 421

School Supplies for Homeless Children Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 422

State Parks Protection Fund/Parks Pass Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 423

Protect Our Coast and Oceans Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 424

Keep Arts in Schools Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 425

American Red Cross, California Chapters Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 426

110 Add code 400 through code 426. This is your total contribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110

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0

ALEJANDRO 6 1 5 8 8 8 6 5 7

Form 540 C1 2013 Side 53105133

111 AMOUNT YOU OWE. Add line 94, line 95, and line 110. See instructions. Do not send cash. Mail to: FRANCHISE TAX BOARD

PO BOX 942867 SACRAMENTO CA 94267-0001 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111

Pay online – Go to ftb.ca.gov for more information.

Am

ou

nt

You

Ow

eIn

tere

st a

nd

P

enal

ties 112 Interest, late return penalties, and late payment penalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .112 00

113 Underpayment of estimated tax. Check the box: FTB 5805 attached FTB 5805F attached 113

114 Total amount due. See instructions. Enclose, but do not staple, any payment . . . . . . . . . . . . . . . . . . . . . . .114

Your email address (optional). Enter only one email address. Daytime phone number (optional)

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) PTIN

Firm’s address FEIN

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

IMPORTANT: See the instructions to find out if you should attach a copy of your complete federal tax return.

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.

SignHereIt is unlawful to forge a spouse’s/RDP’s signature.

Joint tax return?(See instructions)

115 REFUND OR NO AMOUNT DUE. Subtract line 95 and line 110 from line 93. See instructions. Mail to: FRANCHISE TAX BOARD PO BOX 942840 SACRAMENTO CA 94240-0001 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115

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. 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

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

Savings

Ref

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. 00,,

. 00,,

. 00,,

. 00,,

( )

( )

Your name: Your SSN or ITIN:

Your signature Date Spouse’s/RDP’s signature (if a joint tax return, both must sign)

X X

EFILE ONLY DO NOT PAPER FILE.

0✔

(56

0

ZEVCO

✔

✔

0

8 9 6

6 1 5 8 8 8 6 5 7ALEJANDRO

P 0 1 0 6 5 4 7 9

8 9 6

3 2 2 2 7 1 6 2 7

7857 E FLORENCE AVE STE 208, DOWNEY, 90240, CA 9 0 0 5 4 4 8 7 1

4 8 8 3 4 3 0 8 4 8

FTB 8879 C2 2013For Privacy Notice, get FTB 1131 ENG/SP.

TAXABLE YEAR

2013FORM

8879

DO NOT MAIL THIS FORM TO THE FTB

California e-fle Signature Authorization for Individuals

Spouse’s/RDP’s name Spouse’s/RDP’s SSN or ITIN

Your name Your SSN or ITIN

Part I Tax Return Information (whole dollars only)

1 California Adjusted Gross Income (Form 540, line 17; Form 540 2EZ, line 16; Long Form 540NR, line 32; or Short Form 540NR, line 32) 1 2 Amount You Owe (Form 540, line 111; Form 540 2EZ, line 27; Long Form 540NR, line 121; or Short Form 540NR, line 121) 2 3 Refund or No Amount Due (Form 540, line 115; Form 540 2EZ, line 28; Long Form 540NR, line 125; or Short Form 540NR, line 125) 3

Part II Taxpayer Declaration and Signature Authorization (Be sure you obtain and keep a copy of your return )Under penalties of perjury, I declare that I have examined a copy of my individual income tax return and accompanying schedules and statements for the tax year ending December 31, 2013, and to the best of my knowledge and belief, it is true, correct, and complete I further declare that the information I provided to my Electronic Return Originator (ERO), Transmitter, or Intermediate Service Provider (including my name, address, and social security number or individual tax identifcation number) and the amounts shown in Part I above agree with the information and amounts shown on the corresponding lines of my electronic income tax return If applicable, I authorize an electronic funds withdrawal of the amount on line 2 and/or the estimated tax payments as shown on my return and on form FTB 8455, California e-fle Payment Record for Individuals, or a comparable form If applicable, I declare that direct deposit refund amount on line 3 agrees with the direct deposit authorization stated on my return If I have fled a joint return, this is an irrevocable appointment of the other spouse/RDP as an agent to authorize an electronic funds withdrawal or direct deposit I authorize my ERO, Transmitter, or Intermediate Service Provider to transmit my complete return to the Franchise Tax Board (FTB) If the processing of my return or refund is delayed, I authorize the FTB to disclose to my ERO, Intermediate Service Provider, and/or Transmitter the reason(s) for the delay or the date when the refund was sent. If I am fling a balance due return, I understand that if the FTB does not receive full and timely payment of my tax liability, I remain liable for the tax liability and all applicable interest and penalties I acknowledge that I have read and consent to the Electronic Funds Withdrawal Consent included on the copy of my electronic income tax return I have selected a personal identifcation number (PIN) as my signature for my electronic income tax return and, if applicable, my Electronic Funds Withdrawal Consent

Taxpayer’s PIN: check one box only

□ I authorize to enter my PIN ERO frm name Do not enter all zeros as my signature on my 2013 e-fled California individual income tax return

□ I will enter my PIN as my signature on my 2013 e-fled California individual income tax return Check this box only if you are entering your own PIN and your return is fled using the Practitioner PIN method The ERO must complete Part III below

Your signature Date

Spouse’s/RDP’s PIN: check one box only

□ I authorize to enter my PIN ERO frm name Do not enter all zeros as my signature on my 2013 e-fled California individual income tax return

□ I will enter my PIN as my signature on my 2013 e-fled California individual income tax return Check this box only if you are entering your own PIN and your return is fled using the Practitioner PIN method The ERO must complete Part III below

Spouse’s/RDP’s signature Date Practitioner PIN Method Returns Only -- continue below

Part III Certifcation and Authentication — Practitioner PIN Method Only

ERO’s EFIN/PIN. Enter your six-digit EFIN followed by your fve-digit self-selected PIN Do not enter all zerosI certify that the above numeric entry is my PIN, which is my signature for the 2013 California individual income tax return for the taxpayer(s) indicated above I confrm that I am submitting this return in accordance with the requirements of the Practitioner PIN method and FTB Pub 1345, 2013 e-fle Handbook for Authorized e-fle Providers

ERO’s signature Date

EFILE ONLY DO NOT PAPER FILE.

03/17/2014

896

9 6 7 3 6 4 1 7 2 4 2

ZEVCO

0

✔

66249

ALEJANDRO GARIBAY 615-88-8657

1 7 5 6 8

Schedule CA (540) 2013 Side 1

Part I Income Adjustment Schedule Federal Amounts Subtractions Additions A (taxable amounts from B See instructions C See instructionsSection A – Income your federal tax return)

7 Wages, salaries, tips, etc. See instructions before making an entry in column B or C . . . . 7 8 Taxable interest (b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8(a) 9 Ordinary dividends. See instructions. (b) . . . . . . . . . . .9(a) 10 Taxable refunds, credits, offsets of state and local income taxes . . . . . . . . . . . . . . . . . . . 10 11 Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 12 Business income or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 13 Capital gain or (loss). See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 14 Other gains or (losses) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 15 IRA distributions. See instructions. (a) . . . . . . . . . . . . . . . .15(b) 16 Pensions and annuities. See instructions. (a) . . . . . . . . . . .16(b) 17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. . . . . . . . . . . . . . . . 17 18 Farm income or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 19 Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 20 Social security benefits (a) . . . . . . . . . . . . . . . . . . . . . . . .20(b) 21 Other income. a a a California lottery winnings e NOL from FTB 3805D, 3805Z, b b b Disaster loss carryover from FTB 3805V 3806, 3807, or 3809 21 c _____________ c c Federal NOL (Form 1040, line 21) f Other (describe): d d d NOL carryover from FTB 3805V e e f f 22 Total. Combine line 7 through line 21 in column A. Add line 7 through line 21f in

column B and column C. Go to Section B. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Section B – Adjustments to Income

23 Educator expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 24 Certain business expenses of reservists, performing artists, and fee-basis

government officials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 25 Health savings account deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 26 Moving expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

27 Deductible part of self-employment tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 28 Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 29 Self-employed health insurance deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 30 Penalty on early withdrawal of savings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 31a Alimony paid. (b) Recipient’s: SSN – –

Last name . . . 31a 32 IRA deduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 33 Student loan interest deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 34 Tuition and fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 35 Domestic production activities deduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

36 Add line 23 through line 31a and line 32 through line 35 in columns A, B, and C. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

37 Total. Subtract line 36 from line 22 in columns A, B, and C. See instructions . . . . . . . . 37

SSN or ITINName(s) as shown on tax return

7731133

{

California Adjustments — ResidentsSCHEDULE

CA (540)TAXABLE YEAR

2013Important: Attach this schedule behind Form 540, Side 5 as a supporting California schedule.

For Privacy Notice, get FTB 1131 ENG/SP.

EFILE ONLY DO NOT PAPER FILE.

-59420

0

0

193

0

1930

193 0

00 0

0

00

0

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00

000

000

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000

0

00

193

0 0

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0

ALEJANDRO GARIBAY

030

6 1 5 - 8 8 - 8 6

000

66442

0

Side 2 Schedule CA (540) 2013 7732133

Part II Adjustments to Federal Itemized Deductions

38 Federal itemized deductions. Enter the amount from federal Schedule A (Form 1040), lines 4, 9, 15, 19, 20, 27, and 28 . . . . . . 38

39 Enter total of federal Schedule A (Form 1040), line 5 (State Disability Insurance, and state and local income tax, or General Sales Tax), and line 8 (foreign income taxes only). See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

40 Subtract line 39 from line 38 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

41 Other adjustments including California lottery losses. See instructions. Specify . . . . 41

42 Combine line 40 and line 41 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

43 Is your federal AGI (Form 540, line 13) more than the amount shown below for your filing status? Single or married/RDP filing separately . . . . . . . . . . . . . . . . . . . . . . . . . . . . $172,615 Head of household . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $258,927 Married/RDP filing jointly or qualifying widow(er) . . . . . . . . . . . . . . . . . . . . $345,235

No. Transfer the amount on line 42 to line 43. Yes. Complete the Itemized Deductions Worksheet in the instructions for Schedule CA (540), line 43 . . . . . . . . . . . . . . . . . . . . 43

44 Enter the larger of the amount on line 43 or your standard deduction listed below Single or married/RDP filing separately . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $3,906

Married/RDP filing jointly, head of household, or qualifying widow(er) . . . . . . $7,812 Transfer the amount on line 44 to Form 540, line 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

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25181

1224

23957

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23957

23957

23957

Schedule P (540) 2013 Side 1For Privacy Notice, get FTB 1131 ENG/SP.

Alternative Minimum Tax andCredit Limitations — Residents

TAXABLE YEAR

2013Attach this schedule to Form 540.Names as shown on Form 540

7971133

CALIFORNIA SCHEDULE

P (540)Your SSN or ITIN

-Part I Alternative Minimum Taxable Income (AMTI) Important: See instructions for information regarding California/federal differences.

- 1 If you itemized deductions, go to line 2. If you did not itemize deductions, enter your standard deduction from Form 540, line 18, and go to line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 ______________________ 2 Medical and dental expense. Enter the smaller of Schedule A (Form 1040), line 4, or 2½% (.025) of Form 1040, line 37 . . 2 ______________________ 3 Personal property taxes and real property taxes. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 ______________________ 4 Certain interest on a home mortgage not used to buy, build, or improve your home. See instructions . . . . . . . . . . . . . . . . . 4 ______________________ 5 Miscellaneous itemized deductions. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 ______________________ 6 Refund of personal property taxes and real property taxes. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 ______________________ Do not include your state income tax refund on this line. 7 Investment interest expense adjustment. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 ______________________ 8 Post-1986 depreciation. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 ______________________ 9 Adjusted gain or loss. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 ______________________10 Incentive stock options and California qualified stock options (CQSOs). See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . 10 ______________________11 Passive activities adjustment. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 ______________________12 Beneficiaries of estates and trusts. Enter the amount from Schedule K-1 (541), line 12a . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 ______________________13 Other adjustment and preferences. Enter the amount, if any, for each item, a through I, and enter the total on line 13. See instructions.

13 ______________________14 Total Adjustments and Preferences. Combine line 1 through line 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 ______________________15 Enter taxable income from Form 540, line 19. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 ______________________16 Net operating loss (NOL) deductions from Schedule CA (540), line 21d and line 21e, column B. Enter as a positive amount 16 ______________________17 AMTI exclusion. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 ______________________18 If your federal adjusted gross income (AGI) is less than the amount for your filing status (listed below), skip this line and go to line 19. If you itemized deductions and your federal AGI is more than the amount for your filing status, see instructions. 18 ______________________ Single or married/RDP filing separately . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $172,615 Married/RDP filing jointly or qualifying widow(er) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $345,235 Head of household . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$258,92719 Combine line 14 through line 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 ______________________20 Alternative minimum tax NOL deduction. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 ______________________21 Alternative Minimum Taxable Income . Subtract line 20 from line 19 (if married/RDP filing separately and line 21 is more than $327,976, see instructions). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 ______________________Part II Alternative Minimum Tax (AMT)22 Exemption Amount . (If this schedule is for a certain child under age 24, see instructions.) If your filing status is: And line 21 is not over: Enter on line 22: Single or head of household $238,051 $63,481 Married/RDP filing jointly or qualifying widow(er) $317,401 $84,640 22 ______________________ Married/RDP filing separately $158,700 $42,319 } If Part I, line 21 is more than the amount shown above for your filing status, see instructions.23 Subtract line 22 from line 21. If zero or less, enter -0-. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 ______________________24 Tentative Minimum Tax. Multiply line 23 by 7.0% (.07) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 ______________________25 Regular tax before credits from Form 540, line 31. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 ______________________26 Alternative Minimum Tax . Subtract line 25 from line 24. If zero or less, enter -0- here and on Form 540, line 61. If more than zero, enter here and on Form 540, line 61. If you make estimated tax payments for taxable year 2014, enter amount from line 26 on the 2014 Form 540-ES, Estimated Tax Worksheet, line 16. (Exception: If you have carryover credit for solar energy or commercial solar energy, first enter the result on Side 2, Part III, Section C, line 24 or 25) . . . . . . . . . . . . . . . . . 26 ______________________

( )

( )

( )

a Circulation expenditures . . b Depletion . . . . . . . . . . . . . . c Installment sales . . . . . . . . d Intangible drilling costs . . . e Long-term contracts . . . . . f Loss limitations . . . . . . . . .

g Mining costs . . . . . . . . . . . . h Patron’s adjustment. . . . . . . i Pollution control facilities . . j Research and experimental . k Tax shelter farm activities . . l Related adjustments . . . . . .

000000000000

000000000000

0000000000

00

0000

00

00

000000

00

000000000000

000000000000

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0

6098

0

23957

0

821

0

0

2902

0

0

A L E J A N D R O G A R I B A Y

98847

23957

6 1 5 8 8 8 6 5 7

0

000

42292

98847

32598

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Side 2 Schedule P (540) 2013 7972133

0000

Part III Credits that Reduce Tax Note: Be sure to attach your credit forms to Form 540.

1 Enter the amount from Form 540, line 35. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 _____________________ 2 Enter the tentative minimum tax from Side 1, Part II, line 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 _____________________

(a) Credit

amount

(b) Credit used

this year

(c) Tax balance that may be offset

by credits

(d) Credit

carryoverSection A – Credits that reduce excess tax .

3 Subtract line 2 from line 1. If zero or less enter -0- and see instructions. This is your excess tax which may be offset by credits . . . . . . . . . . . . . . . . . . . . . . 3A1 Credits that reduce excess tax and have no carryover provisions . 4 Code: 162 Prison inmate labor credit (FTB 3507). . . . . . . . . . . . . . . . . . . . . . . . . . . 4 5 Code: 169 Enterprise zone employee credit (FTB 3553) . . . . . . . . . . . . . . . . . . . . . . 5 6 Code: 221 2010 New Home Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 7 Code: 232 Child and dependent care expenses credit (FTB 3506) . . . . . . . . . . . . . . 7A2 Credits that reduce excess tax and have carryover provisions . See instructions . 8 Code: ____ ____ ____ Credit Name: 8 9 Code: ____ ____ ____ Credit Name: 9 10 Code: ____ ____ ____ Credit Name: 10 11 Code: ____ ____ ____ Credit Name: 11 12 Code: 188 Credit for prior year alternative minimum tax . . . . . . . . . . . . . . . . . . . . . 12 Section B – Credits that may reduce tax below tentative minimum tax .13 If Part III, line 3 is zero, enter the amount from line 1. If line 3 is more than zero, enter the total of line 2 and the last entry in column (c). . . . . . . . . . . . . . . . . . 13B1 Credits that reduce net tax and have no carryover provisions .14 Code: 170 Credit for joint custody head of household . . . . . . . . . . . . . . . . . . . . . . . 1415 Code: 173 Credit for dependent parent. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1516 Code: 163 Credit for senior head of household . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1617 Nonrefundable renter’s credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17B2 Credits that reduce net tax and have carryover provisions . See instructions .18 Code: ____ ____ ____ Credit Name: 18 19 Code: ____ ____ ____ Credit Name: 19 20 Code: ____ ____ ____ Credit Name: 20 21 Code: ____ ____ ____ Credit Name: 21 B3 Other state tax credit .22 Code: 187 Other state tax credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22Section C – Credits that may reduce alternative minimum tax .23 Enter your alternative minimum tax from Side 1, Part II, line 26 . . . . . . . . . . . . . . . 2324 Code: 180 Solar energy credit carryover from Section B2, column (d) . . . . . . . . . . 24 25 Code: 181 Commercial solar energy credit carryover from Section B2, column (d) . . 25 26 Adjusted AMT. Enter the balance from line 25, column (c) here and on Form 540, line 61 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

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STATEMENT Other Deductible

Amount Type of Other deductions

DMV REGISTRATION 265

STATEMENT

Description Amount

BUSINESS ATTIRE 1448

(New line) Stmt Other withholding source document form name

1099INT 0