Electronic Filing Instructions for your 2019 Federal Tax Return

Important: Your taxes are not finished until all required steps are completed.

Edgar A Lopez
281 Padua Hills Pl, Apt. F
San Ysidro, CA 92173-2171
|
Balance | Your federal tax return (Form 1040) shows a refund due to you in the
Due/ | amount of $1,343.00. Your tax refund will be direct deposited into
Refund | your account. The account information you entered - Account Number:
| 325109567145 Routing Transit Number: 121000358.
|
______________________________________________________________________________________
|
When Will | The IRS issued more than 9 out of 10 refunds to taxpayers in less
You Get | than 21 days last year. The same results are expected in 2020. To
Your | get your estimated refund date from TurboTax, log into My TurboTax at
Refund? | www.turbotax.com. If you do not receive your refund within 21 days,
| or the amount you get is not what you expected, contact the Internal
| Revenue Service directly at 1-800-829-4477. You can also check
| www.irs.gov and select the "Where's my refund?" link.
|
______________________________________________________________________________________
|
What You | Your Electronic Filing Instructions (this form)
Need to | Printed copy of your federal return
Keep |
|
______________________________________________________________________________________
|
2019 | Adjusted Gross Income $ 8,483.00
Federal | Taxable Income $ 0.00
Tax | Total Tax $ 0.00
Return | Total Payments/Credits $ 1,343.00
Summary | Amount to be Refunded $ 1,343.00
| Effective Tax Rate -6.24%
|
______________________________________________________________________________________

Page 1 of 1
Hi Edgar,

We just want to thank you for using TurboTax this year! It's our goal to make
your taxes easy and accurate, year after year.

With TurboTax Federal Free Edition:

- Your filed return has 100% guaranteed accurate calculations*
- You received a printed copy of your return with supporting documents for your
records

Many happy returns from TurboTax.

 1040 U.S. Individual Income Tax Return 2019
Form Department of the Treasury—Internal Revenue Service (99)
OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.

Filing Status Single Married filing jointly Married filing separately (MFS) Head of household (HOH) Qualifying widow(er) (QW)
Check only If you checked the MFS box, enter the name of spouse. If you checked the HOH or QW box, enter the child’s name if the qualifying person is
one box.
a child but not your dependent. a
Your first name and middle initial Last name Your social security number
Edgar A Lopez 610-68-7869
If joint return, spouse’s first name and middle initial Last name Spouse’s social security number

Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Presidential Election Campaign
Check here if you, or your spouse if filing
281 Padua Hills Pl F
jointly, want $3 to go to this fund.
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Checking a box below will not change your
San Ysidro CA 92173-2171 tax or refund. You Spouse
Foreign country name Foreign province/state/county Foreign postal code If more than four dependents,
see instructions and  here a

Standard Someone can claim: You as a dependent Your spouse as a dependent

Deduction Spouse itemizes on a separate return or you were a dual-status alien

Age/Blindness You: Were born before January 2, 1955 Are blind Spouse: Was born before January 2, 1955 Is blind
Dependents (see instructions): (2) Social security number (3) Relationship to you (4)  if qualifies for (see instructions):
(1) First name Last name Child tax credit Credit for other dependents

1 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . . . . . 1 8,483.

2a Tax-exempt interest . . . . 2a b Taxable interest. Attach Sch. B if required 2b
3a Qualified dividends . . . . 3a b Ordinary dividends. Attach Sch. B if required 3b
Standard
Deduction for— 4a IRA distributions . . . . . 4a b Taxable amount . . . . . . 4b
• Single or Married
filing separately,
c Pensions and annuities . . . 4c d Taxable amount . . . . . . 4d
$12,200 5a Social security benefits . . . 5a b Taxable amount . . . . . . 5b
• Married filing
6 Capital gain or (loss). Attach Schedule D if required. If not required, check here . . . . . . . a 6
jointly or Qualifying
widow(er), 7a Other income from Schedule 1, line 9 . . . . . . . . . . . . . . . . . . . . 7a
$24,400
• Head of b Add lines 1, 2b, 3b, 4b, 4d, 5b, 6, and 7a. This is your total income . . . . . . . . . . . a 7b 8,483.
household,
$18,350
8a Adjustments to income from Schedule 1, line 22 . . . . . . . . . . . . . . . . . 8a
• If you checked b Subtract line 8a from line 7b. This is your adjusted gross income . . . . . . . . . . . a 8b 8,483.
any box under
Standard 9 Standard deduction or itemized deductions (from Schedule A) . . . . . 9 12,200.
Deduction, 10 Qualified business income deduction. Attach Form 8995 or Form 8995-A . . . 10
see instructions.
11a Add lines 9 and 10 . . . . . . . . . . . . . . . . . . . . . . . . . 11a 12,200.
b Taxable income. Subtract line 11a from line 8b. If zero or less, enter -0- . . . . . . . . . . . 11b 0.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2019)
 Form 1040 (2019) Page 2
12a Tax (see inst.) Check if any from Form(s): 1 8814 2 4972 3 12a 0.
b Add Schedule 2, line 3, and line 12a and enter the total . . . . . . . . . . . . . . a 12b 0.
13a Child tax credit or credit for other dependents . . . . . . . . . . 13a
b Add Schedule 3, line 7, and line 13a and enter the total . . . . . . . . . . . . . . a 13b
14 Subtract line 13b from line 12b. If zero or less, enter -0- . . . . . . . . . . . . . . . 14 0.
15 Other taxes, including self-employment tax, from Schedule 2, line 10 . . . . . . . . . . . . 15 0.
16 Add lines 14 and 15. This is your total tax . . . . . . . . . . . . . . . . . . a 16 0.
17 Federal income tax withheld from Forms W-2 and 1099 . . . . . . . . . . . . . . . 17 814.
• If you have a
18 Other payments and refundable credits:
qualifying child, a Earned income credit (EIC) . . . . . . . . . . . . . . . 18a 529.
attach Sch. EIC.
• If you have b Additional child tax credit. Attach Schedule 8812 . . . . . . . . . 18b
nontaxable c American opportunity credit from Form 8863, line 8 . . . . . . . . 18c
combat pay, see
instructions. d Schedule 3, line 14 . . . . . . . . . . . . . . . . . 18d
e Add lines 18a through 18d. These are your total other payments and refundable credits . . . . . a 18e 529.
19 Add lines 17 and 18e. These are your total payments . . . . . . . . . . . . . . . a 19 1,343.
Refund 20 If line 19 is more than line 16, subtract line 16 from line 19. This is the amount you overpaid . . . . . . 20 1,343.
21a Amount of line 20 you want refunded to you. If Form 8888 is attached, check here . . . . . . a 21a 1,343.
Direct deposit? a b Routing number 1 2 1 0 0 0 3 5 8 a c Type: Checking Savings
See instructions.
a d Account number 3 2 5 1 0 9 5 6 7 1 4 5
22 Amount of line 20 you want applied to your 2020 estimated tax . . . . a 22
Amount 23 Amount you owe. Subtract line 19 from line 16. For details on how to pay, see instructions . . . . . a 23
You Owe 24 Estimated tax penalty (see instructions) . . . . . . . . . . . a 24
Third Party Do you want to allow another person (other than your paid preparer) to discuss this return with the IRS? See instructions. Yes. Complete below.
Designee No
(Other than Designee’s Phone Personal identification
paid preparer) name a no. a number (PIN) a

Sign Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true,
correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Here Your signature Date Your occupation If the IRS sent you an Identity
Protection PIN, enter it here
F

Joint return? Student (see inst.)

See instructions. Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent your spouse an
Keep a copy for Identity Protection PIN, enter it here
your records. (see inst.)

Phone no. Email address

Preparer’s name Preparer’s signature Date PTIN Check if:
Paid 3rd Party Designee
Preparer Self-employed
Firm’s name a Self-Prepared Phone no.
Use Only
Firm’s address a Firm’s EIN a

Go to www.irs.gov/Form1040 for instructions and the latest information. BAA REV 02/06/20 TTO Form 1040 (2019)
Electronic Filing Instructions for your 2019 California Tax Return
Important: Your taxes are not finished until all required steps are completed.

Edgar A Lopez
281 Padua Hills Pl APT F
San Ysidro, CA 92173-2171
|
Balance | Your California state tax return (Form 540) shows a refund due to you
Due/ | in the amount of $184.00. Your tax refund will be direct deposited
Refund | into your account. The account information you entered - Account
| Number: 325109567145 Routing Transit Number: 121000358.
|
______________________________________________________________________________________
|
Where's My | Before you call the Franchise Tax Board with questions about your
Refund? | refund, give them 21 days processing time from the date your return
| is accepted. If then you have not received your refund, or the amount
| is not what you expected, contact the Franchise Tax Board directly at
| 1-800-338-0505. From outside of California use 1-916-845-6500. You
| can also visit the Franchise Tax Board web site at
| http://www.ftb.ca.gov/online/refund/.
|
______________________________________________________________________________________
|
What You | Sign and date Form 8453-OL within 1 day of acceptance.
Need to |
Sign |
|
______________________________________________________________________________________
|
Do Not | Do not mail a paper copy of your tax return. Since you filed
Mail | electronically, the Franchise Tax Board already has your return.
|
______________________________________________________________________________________
|
What You | Your Electronic Filing Instructions (this form)
Need to | - Form 8453-OL and attachment(s)
Keep | Printed copy of your state and federal returns
|
______________________________________________________________________________________
|
2019 | Taxable Income $ 3,946.00
California | Total Tax $ 0.00
Tax | Total Payments/Credits $ 184.00
Return | Amount to be Refunded $ 184.00
Summary | Effective Tax Rate 0.00%
|
______________________________________________________________________________________

Page 1 of 1
175
Date Accepted DO NOT MAIL THIS FORM TO THE FTB
TAXABLE YEAR California Online e-file Return Authorization FORM

2019 for Individuals 8453-OL

Your first name and initial Last name Suffix Your SSN or ITIN
EDGAR A LOPEZ 610-68-7869
If filing jointly, spouse’s/RDP’s first name Last name Suffix Spouse’s/RDP’s SSN or ITIN

Street address (number and street) or PO box Apt. no. PMB/private mailbox Daytime telephone number
281 PADUA HILLS PL APT F (619)802-3864
City State ZIP code
SAN YSIDRO CA 92173-2171
Foreign country name Foreign province/state/county Foreign postal code

Part I Tax Return Information (whole dollars only)

1 California adjusted gross income. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 8,483.

2 Refund or no amount due. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 184.

3 Amount you owe. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Part II Settle Your Account Electronically for Taxable Year 2019 (Payment due 4/15/2020)
4 Direct deposit of refund
5 Electronic funds withdrawal 5a Amount 5b Withdrawal date (mm/dd/yyyy)
Part III Make Estimated Tax Payments for Taxable Year 2020 These are not installment payments for the current amount you owe.
First Payment Second Payment Third Payment Fourth Payment
Due 4/15/2020 Due 6/15/2020 Due 9/15/2020 Due 1/15/2021
6 Amount
7 Withdrawal date
Part IV Banking Information (Have you verified your banking information?)
8 Amount of refund to be directly deposited to account below 184. 12 The remaining amount of my refund for direct deposit
9 Routing number 121000358 13 Routing number
10 Account number 325109567145 14 Account number
11 Type of account: Checking Savings 15 Type of account: Checking Savings
Part V Declaration of Taxpayer(s)
I authorize my account to be settled as designated in Part II. If I check Part II, box 4, I declare that the direct deposit refund information in
Part IV agrees with the authorization stated on my return. I authorize an electronic funds withdrawal for the amount listed on line 5a and
any estimated payment amounts listed on line 6 from the bank account listed on lines 9, 10, and 11. If I have filed a joint return, this is an
irrevocable appointment of the other spouse/RDP as an agent to receive the refund or authorize an electronic funds withdrawal.
Under penalties of perjury, I declare that the information I provided to the Franchise Tax Board (FTB), either directly or through e-file
software, including my name, address, and social security number (SSN) or individual taxpayer identification number (ITIN), and the
amounts shown in Part I above, agrees with the information and amounts shown on the corresponding lines of my 2019 California income
tax return. To the best of my knowledge and belief, my return is true, correct, and complete. If I am filing 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 authorize my return and accompanying schedules and statements to be transmitted to the FTB directly or through the e-file
software. If the processing of my return or refund is delayed, I authorize the FTB to disclose to me, either directly or through the e-file
software, the reason(s) for the delay or the date when the refund was sent.

Sign Your signature Date

Here

Spouse’s/RDP’s signature. If filing jointly, both must sign. Date

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

For Privacy Notice, get FTB 1131 ENG/SP. REV 02/07/20 TTO FTB 8453-OL 2019
 TAXABLE YEAR FORM

2019 California Resident Income Tax Return 540

APE DO NOT ATTACH FEDERAL RETURN
610-68-7869 LOPE 19
EDGAR A LOPEZ

281 PADUA HILLS PL APT F

SAN YSIDRO CA 92173-2171

09-07-1992

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

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

Filing Status

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

See instructions.

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

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

▶ For line 7, line 8, line 9, and line 10: Multiply the number you enter in the box by the pre-printed dollar amount for that line. Whole dollars only
7 Personal: If you checked box 1, 3, or 4 above, enter 1 in the box. If you checked
box 2 or 5, enter 2 in the box. If you checked the box on line 6, see instructions. 7 1 X $122 = 쐌 $ 122
8 Blind: If you (or your spouse/RDP) are visually impaired, enter 1;
if both are visually impaired, enter 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 X $122 = $
Exemptions

9 Senior: If you (or your spouse/RDP) are 65 or older, enter 1;

if both are 65 or older, enter 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ●9 X $122 = $
10 Dependents: Do not include yourself or your spouse/RDP.
Dependent 1 Dependent 2 Dependent 3
First Name

Last Name

SSN ● ● ●
Dependent's
relationship
to you

Total dependent exemptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 10 X $378 = $

REV 02/07/20 TTO

175 3101194 Form 540 2019 Side 1

Your name: LOPEZ Your SSN or ITIN: 610-68-7869

11 Exemption amount: Add line 7 through line 10. Transfer this amount to line 32 . . . . . . . . . . 11 $ 122

12 State wages from your federal Form(s) W-2,

box 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 12 2933 . 00

13 Enter federal adjusted gross income from federal Form 1040 or 1040-SR, line 8b . . . . . . . . 13 8483 . 00
14 California adjustments – subtractions. Enter the amount from Schedule CA (540),
Part I, line 23, column B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 14 . 00
15 Subtract line 14 from line 13. If less than zero, enter the result in parentheses.
8483 . 00
Taxable Income

See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
16 California adjustments – additions. Enter the amount from Schedule CA (540),
Part I, line 23, column C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 16 . 00

17 California adjusted gross income. Combine line 15 and line 16 . . . . . . . . . . . . . . . . . . . . . . . ● 17 8483 . 00

{ {
18 Enter the Your California itemized deductions from Schedule CA (540), Part II, line 30; OR
larger of Your California standard deduction shown below for your filing status:
• Single or Married/RDP filing separately. . . . . . . . . . . . . . . . . . . . . . . . . . . . . $4,537
• Married/RDP filing jointly, Head of household, or Qualifying widow(er) . . . . $9,074
If Married/RDP filing separately or the box on line 6 is checked, STOP. See instructions ● 18 4537 . 00
19 Subtract line 18 from line 17. This is your taxable income.
If less than zero, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 3946 . 00

Tax Table Tax Rate Schedule

31 Tax. Check the box if from:
● FTB 3800 ● FTB 3803 . . . . . . . . . . . . . . . . ● 31 39 . 00
32 Exemption credits. Enter the amount from line 11. If your federal AGI is more than $200,534,
see instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 122 . 00
Tax

33 Subtract line 32 from line 31. If less than zero, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 0 . 00

34 Tax. See instructions. Check the box if from: ● Schedule G-1 ● FTB 5870A . . ● 34 . 00

35 Add line 33 and line 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 0 . 00

40 Nonrefundable Child and Dependent Care Expenses Credit. See instructions. . . . . . . . . . . . . ● 40 . 00

43 Enter credit name code ● and amount . . . ● 43 . 00

Special Credits

44 Enter credit name code ● and amount . . . ● 44 . 00

45 To claim more than two credits. See instructions. Attach Schedule P (540). . . . . . . . . . . . . . ● 45 . 00

46 Nonrefundable renter’s credit. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 46 60 . 00

47 Add line 40 through line 46. These are your total credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 60 . 00

48 Subtract line 47 from line 35. If less than zero, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 0 . 00

REV 02/07/20 TTO

Side 2 Form 540 2019 175 3102194

Your name: LOPEZ Your SSN or ITIN: 610-68-7869

61 Alternative minimum tax. Attach Schedule P (540) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 61 . 00

Other Taxes

62 Mental Health Services Tax. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 62 . 00

63 Other taxes and credit recapture. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 63 . 00

64 Add line 48, line 61, line 62, and line 63. This is your total tax. . . . . . . . . . . . . . . . . . . . . . . . ● 64 0 . 00

71 California income tax withheld. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 71 16 . 00

72 2019 CA estimated tax and other payments. See instructions . . . . . . . . . . . . . . . . . . . . . . . . ● 72 . 00

73 Withholding (Form 592-B and/or 593). See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 73 . 00

Payments

74 Excess SDI (or VPDI) withheld. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 74 . 00

75 Earned Income Tax Credit (EITC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 75 168 . 00

76 Young Child Tax Credit (YCTC). See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 76 . 00

77 Add lines 71 through 76. These are your total payments.
See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
184 . 00

91 Use Tax. Do not leave blank. See instructions . . . . . . . . . . . . . . . . . . . . . . ● 91 0 . 00

Use Tax

If line 91 is zero, check if: No use tax is owed.

You paid your use tax obligation directly to CDTFA.

92 Payments balance. If line 77 is more than line 91, subtract line 91 from line 77 . . . . . . . . . . 92 184 . 00
Overpaid Tax/Tax Due

93 Use Tax balance. If line 91 is more than line 77, subtract line 77 from line 91 . . . . . . . . . . . 93 . 00

94 Overpaid tax. If line 92 is more than line 64, subtract line 64 from line 92. . . . . . . . . . . . . . . 94 184 . 00

95 Amount of line 94 you want applied to your 2020 estimated tax . . . . . . . . . . . . . . . . . . . . . . ● 95 . 00

96 Overpaid tax available this year. Subtract line 95 from line 94 . . . . . . . . . . . . . . . . . . . . . . . . ● 96 184 . 00
97 Tax due. If line 92 is less than line 64, subtract line 92 from line 64 . . . . . . . . . . . . . . . . . . . 97 . 00

REV 02/07/20 TTO

175 3103194 Form 540 2019 Side 3

Your name: LOPEZ Your SSN or ITIN: 610-68-7869

Code Amount

California Seniors Special Fund. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 400 . 00

Alzheimer’s Disease and Related Dementia Voluntary Tax Contribution Fund . . . . . . . . . . . . . ● 401 . 00

Rare and Endangered Species Preservation Voluntary Tax Contribution Program . . . . . . . . . ● 403 . 00

California Breast Cancer Research Voluntary Tax Contribution Fund. . . . . . . . . . . . . . . . . . . . ● 405 . 00

California Firefighters’ Memorial Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 406 . 00

Emergency Food for Families Voluntary Tax Contribution Fund . . . . . . . . . . . . . . . . . . . . . . . ● 407 . 00

California Peace Officer Memorial Foundation Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 408 . 00

California Sea Otter Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 410 . 00

California Cancer Research Voluntary Tax Contribution Fund . . . . . . . . . . . . . . . . . . . . . . . . . ● 413 . 00

● . 00
Contributions

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

State Parks Protection Fund/Parks Pass Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 423 . 00

Protect Our Coast and Oceans Voluntary Tax Contribution Fund. . . . . . . . . . . . . . . . . . . . . . . ● 424 . 00

Keep Arts in Schools Voluntary Tax Contribution Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 425 . 00

Prevention of Animal Homelessness and Cruelty Voluntary Tax Contribution Fund . . . . . . . . ● 431 . 00

California Senior Citizen Advocacy Voluntary Tax Contribution Fund . . . . . . . . . . . . . . . . . . . ● 438 . 00

Native California Wildlife Rehabilitation Voluntary Tax Contribution Fund. . . . . . . . . . . . . . . . ● 439 . 00

Rape Kit Backlog Voluntary Tax Contribution Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 440 . 00

Organ and Tissue Donor Registry Voluntary Tax Contribution Fund . . . . . . . . . . . . . . . . . . . . ● 441 . 00

National Alliance on Mental Illness California Voluntary Tax Contribution Fund . . . . . . . . . . . ● 442 . 00

Schools Not Prisons Voluntary Tax Contribution Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 443 . 00

Suicide Prevention Voluntary Tax Contribution Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ● 444 . 00

110 Add code 400 through code 444. This is your total contribution . . . . . . . . . . . . . . . . . . . . . . ● 110 . 00

REV 02/07/20 TTO

Side 4 Form 540 2019 175 3104194

Your name: LOPEZ Your SSN or ITIN: 610-68-7869
You Owe
Amount

111 AMOUNT YOU OWE. If you do not have an amount on line 96, add line 93, line 97, and line 110. See instructions. Do not send cash.
Mail to: FRANCHISE TAX BOARD, PO BOX 942867, SACRAMENTO CA 94267-0001. . . . . ● 111 . 00
Pay Online – Go to ftb.ca.gov/pay for more information.

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

113 Underpayment of estimated tax.

Check the box: ● FTB 5805 attached ● FTB 5805F attached . . . . . . . . . . . ● 113 . 00

114 Total amount due. See instructions. Enclose, but do not staple, any payment . . . . . . . . . . . . 114 . 00
115 REFUND OR NO AMOUNT DUE. Subtract the sum of 110, line 112 and line 113 from line 96. See instructions.

Mail to: FRANCHISE TAX BOARD, PO BOX 942840, SACRAMENTO CA 94240-0001. . . . . . . ● 115 184 . 00
Fill in the information to authorize direct deposit of your refund into one or two accounts. Do not attach a voided check or a deposit slip.
Refund and Direct Deposit

See instructions. Have you verified the routing and account numbers? Use whole dollars only.
All or the following amount of my refund (line 115) is authorized for direct deposit into the account shown below:
● Type
● Routing number Checking ● Account number ● 116 Direct deposit amount
121000358 325109567145 184 . 00
Savings
The remaining amount of my refund (line 115) is authorized for direct deposit into the account shown below:
● Type
● Routing number ● Account number ● 117 Direct deposit amount
Checking
. 00
Savings
IMPORTANT: See the instructions to find out if you should attach a copy of your complete federal tax return.
To learn about your privacy rights, how we may use your information, and the consequences for not providing the requested information, go to
ftb.ca.gov/forms and search for 1131. To request this notice by mail, call 800.852.5711.
Under penalties of perjury, I declare that I have examined this tax return, including accompanying schedules and statements, and to the best of my
knowledge and belief, it is true, correct, and complete.
Your signature Date Spouse’s/RDP’s signature (if a joint tax return, both must sign)

Your email address. Enter only one email address. Preferred phone number

6198023864
Sign Paid preparer’s signature (declaration of preparer is based on all information of which preparer has any knowledge)
Here
SELF-PREPARED
It is unlawful
to forge a
spouse’s/
Firm’s name (or yours, if self-employed) ● PTIN
RDP’s
signature.
Firm’s address ● Firm’s FEIN
Joint tax
return?
(See
instructions)
Do you want to allow another person to discuss this tax return with us? See instructions . . . . . ● Yes No
Print Third Party Designee’s Name Telephone Number

REV 02/07/20 TTO

175 3105194 Form 540 2019 Side 5

 TAXABLE YEAR FORM

2019 California Earned Income Tax Credit 3514

Attach to your California Form 540, Form 540 2EZ or Form 540NR
Name(s) as shown on tax return SSN

EDGAR A LOPEZ 610687869

Before you begin:
If you claim the EITC even though you know you are not eligible, you may not be allowed to take the credit for up to 10 years.
If you are claiming the California Earned Income Tax Credit (EITC), you must provide your date of birth (DOB), and spouse's/RDP's DOB if filing jointly,
on your California Form 540, Form 540 2EZ, or Form 540NR.
If you qualify for the California EITC you may also qualify for the Young Child Tax Credit (YCTC). See instructions for additional information.
Follow Step 1 through Step 9 in the instructions to determine if you meet the requirements, to complete this form, and to figure the amount of
the credit(s).
Part I Qualifying Information  See Specific Instructions.
  1 a  Has the Internal Revenue Service (IRS) previously disallowed your federal Earned Income Credit (EIC)? . . . . . . □ Yes □ No
b  Has the Franchise Tax Board (FTB) previously disallowed your California EITC?. . . . . . . . . . . . . . . . . . . . . . . . . . □ Yes □ No
 2  Federal AGI (federal Form 1040 or 1040-SR, line 8b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 2 8483 . 00

 3  Federal EIC (federal Form 1040 or 1040-SR, line 18a). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 3 529 . 00
Part II Investment Income Information

 4  Investment Income. See instructions for Step 2 – Investment Income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 4 . 00

Part III Qualifying Child Information
You must complete Part I and Part II before filling out Part III. If you are not claiming a qualifying child, skip Part III and go to Step 4 in the instructions.
Qualifying Child Information Child 1 Child 2 Child 3

 5 First name . . . . . . . . . . . . . . . . . . . . .

 6 Last name . . . . . . . . . . . . . . . . . . . . .

 7 SSN . . . . . . . . . . . . . . . . . . . . . . . . . . • • •
 8 Date of birth (mm/dd/yyyy). If born
after 2000 and the child is younger
than you (or your spouse/RDP, if
filing jointly), skip line 9a and line 9b;
go to line 10 . . . . . . . . . . . . . . . . . . .
 9 a Was the child under age 24
at the end of 2019, a student,
and younger than you (or your
spouse/RDP, if filing jointly)? If
yes, go to line 10. If no, go to
line 9b. See instructions. . . . . . . . . □ Yes □ No □ Yes □ No □ Yes □ No
b Was the child permanently and
totally disabled during any part
of 2019? If yes, go to line 10. If
no, stop here. The child is not a
qualifying child. . . . . . . . . . . . . . . . □ Yes □ No □ Yes □ No □ Yes □ No
10 Child’s relationship to you.
See instructions. . . . . . . . . . . . . . . . .
11 Number of days child lived with you
in California during 2019.
Do not enter more than 365 days.
See instructions. . . . . . . . . . . . . . . . .
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For Privacy Notice, get FTB 1131 ENG/SP. 175 8461194 FTB 3514  2019  Side 1
 Child 1 Child 2 Child 3
12 a Child’s physical address during
2019 (number, street, and apt.
no./ste. no.). See instructions. . . .

b City . . . . . . . . . . . . . . . . . . . . . . . .

c State . . . . . . . . . . . . . . . . . . . . . . .

d ZIP code . . . . . . . . . . . . . . . . . . . .

Part IV California Earned Income

13 Wages, salaries, tips, and other employee compensation, subject to California withholding. See instructions. . . . . • 13 2933 . 00

14 IHSS payments. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 . 00

15 Prison inmate wages and/or pension or annuity from a nonqualified deferred compensation plan or a
nongovernmental IRC Section 457 plan. See instructions.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 . 00
16 Subtract line 14 and line 15 from line 13.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 16 2933 . 00

17 Nontaxable combat pay. See instructions.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 . 00

18 Business income or (loss). Enter amount from Worksheet 3, line 5. See instructions.. . . . . . . . . . . . . . . . . . . . . . 18 . 00
a Business name . . . . . . . . . . . . . . .

b Business address . . . . . . . . . . . . .

City, state, and ZIP code . . . . . . . .

c Business license number . . . . . . . .

d SEIN . . . . . . . . . . . . . . . . . . . . . . .

e Business code . . . . . . . . . . . . . . . .

19 California Earned Income. Add line 16, line 17, and line 18. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 19 2933 . 00
Part V California Earned Income Tax Credit  (Complete Step 6 in the instructions.)
20 California EITC. Enter amount from California Earned Income Tax Credit Worksheet, Part III, line 6.
This amount should also be entered on Form 540, line 75; or Form 540 2EZ, line 23. . . . . . . . . . . . . . . . . . . . . . . . • 20 168 . 00

Side 2  FTB 3514  2019 175 8462194 REV 02/07/20 TTO

Part VI Nonresident or Part-Year Resident California Earned Income Tax Credit

21 CA Exemption Credit Percentage from Form 540NR, line 38. See instructions. . . . . 21
22 Nonresident or Part-Year Resident EITC. Multiply line 20 by line 21.
This amount should also be entered on Form 540NR, line 85. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 22 . 00
Part VII Young Child Tax Credit (YCTC) (See Step 8 in the instructions before completing this part.)

23 California Earned Income. Enter the amount from form FTB 3514, line 19. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 . 00
24 Available Young Child Tax Credit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 1,000 . 00
• If the amount on line 23 is $25,000 or less, also enter $1,000 on line 28 and skip lines
25 through 27. If applicable, complete lines 29 and 30.
• If the amount on line 23 is greater than $25,000, complete lines 25 through 28. If applicable,
complete lines 29 and 30.

25 Excess Earned Income over threshold. Subtract $25,000 from line 23. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 25 . 00
26 Divide line 25 by 100. Enter the result as a decimal out to two decimal places, do not round.. . . . . . . . . . . . . . . . 26

27 Reduction amount. Multiply line 26 by $20. Enter the result as a decimal out to two decimal places,
do not round. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 27

28 Young Child Tax Credit.

• If you did not need to complete lines 25 through 27, your credit is the $1,000 from line 24.
• If you completed lines 25 through 27, to compute your credit, subtract line 27 from line 24. If your credit
amount is between $0 and $1, enter $1. If your credit amount is over $1, round to the nearest whole dollar.
This amount should also be entered on Form 540, line 76; or Form 540 2EZ, line 24. . . . . . . . . . . . . . . . . . . . . . . . • 28 . 00
Part VIII Nonresident or Part-Year Resident Young Child Tax Credit (See Step 9 in the instructions.)

29 CA Exemption Credit Percentage from Form 540NR, line 38. See instructions. . . . 29

30 Nonresident or Part-Year Resident YCTC. Multiply line 29 by line 28.

This amount should also be entered on Form 540NR, line 86. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 30
. 00

175 8463194 REV 02/07/20 TTO FTB 3514  2019  Side 3

 Credits Worksheet 2019
G Keep for your records

Name Social Security Number

Edgar A Lopez 610-68-7869

Code Current Credits Carryover Available

Amount Credit

233 California Competes, FTB 3531

197 Child Adoption
232 Child and Dependent Care Expenses Credit, FTB 3506
235 College Access, FTB 3592
173 Dependent Parent
205 Disabled Access Credit current year amount from Form 3548 line 6
205 Disabled Access for Eligible Small Businesses, FTB 3548
204 Donated Agricultural Products Transportation, FTB 3547
203 Enhanced Oil Recovery, FTB 3546
170 Joint Custody Head of Household
172 Low-Income Housing, FTB 3521
213 Natural Heritage Preservation, FTB 3503
237 New California Motion Picture and Television Production, FTB 3541
238 New Donated Fresh Fruits or Vegetables, FTB 3814
234 New Employment, FTB 3554
None Nonrefundable Renter’s Credit 60.
187 Other State Tax, Schedule S
188 Prior Year Alternative Minimum Tax, FTB 3510
162 Prison Inmate Labor, FTB 3507
183 Research, FTB 3523
163 Senior Head of Household

Repealed Credits with Carryover Provision ' FTB 3540

175 Agricultural Products

223 Motion Picture and Television Production, FTB 3541
196 Commercial Solar Electric System
181 Commercial Solar Energy
209 Community Development Financial Institutions Investment
224 Donated Fresh Fruits or Vegetables Credit
194 Employee Ridesharing
190 Employer Childcare Contribution
189 Employer Childcare Program
191 Employer Ridesharing (Large Employer)
192 Employer Ridesharing (Small Employer)
193 Employer Ridesharing (Public Transit Passes)
182 Energy Conservation
176 Enterprise Zone Hiring, FTB 3805Z
176 Enterprise Zone Sales or Use Tax, FTB 3805Z
218 Environmental Tax
207 Farmworker Housing
198 Local Agency Military Base Recovery Area Hiring, FTB 3807
198 Local Agency Military Base Recovery Area Sales or Use Tax, 3807
160 Low-Emission Vehicles
211 Manufacturing Enhancement Area Hiring, FTB 3808
220 New Jobs
185 Orphan Drug
184 Political Contributions
174 Recycling Equipment
186 Residential Rental and Farm Sales
206 Rice Straw
171 Ridesharing
200 Salmon and Steelhead Trout Habitat Restoration
180 Solar Energy
179 Solar Pump
210 Targeted Tax Area Hiring, FTB 3809
210 Targeted Tax Area Sales or Use Tax, FTB 3809
178 Water Conservation
161 Young Infant