Form 540 2EZ (2024) — California Resident Income Tax Return (Simplified)

# preamble

Your DOB (mm/dd/yyyy) Spouse's/RDP's DOB (mm/dd/yyyy) Your prior name (see instructions) Spouse's/RDP's prior name (see instructions) Date of Birth Prior Name • • • • Y our first name Initial Last name Suffix Y our SSN or ITIN If joint tax return, spouse's/RDP's first name Initial Last name Suffix Spouse's/RDP's SSN or ITIN Additional information (see instructions) 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 Check here if this is an AMENDED return. A R RP 3111243 Form 540 2EZ 2024 Side 1 Check the box for your filing status. Check only one. See instructions. If not, enter below your principal/physical residence address at the time of filing. If your California filing status is different from your federal filing status, check the box here If your address above is the same as your principal/physical residence address at the time of filing, check this box Enter your county at time of filing (see instructions) Street address (number and street) (If foreign address, see instructions.) Apt. no./ste.no. City State ZIP code 2 See instructions. Head of household. STOP! See instructions. If someone can claim you (or your spouse/RDP) as a dependent, check the box here. See instructions Single Married/RDP filing jointly (even if only one spouse/RDP had income) Qualifying surviving spouse/RDP . Enter year spouse/RDP died. Filing Status Principal Residence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 6

# TAXABLE YEAR

2024 California Resident Income Tax Return FORM 540 2EZ

333Side 2 Form 540 2EZ 2024 . 00 26 Use tax. Do not leave blank. See instructions. ......... • 26 If line 26 is zero, check if: No use tax is owed. You paid your use tax obligation directly to CDTFA. Whole dollars only Taxable Income and CreditsUse Tax 8 Dependents: (Do not include yourself or your spouse/RDP) Enter number of dependents here. Exemptions . . . . . . . . . . . . . • 8 • • • Dependent 1 Dependent 2 Dependent 3 First Name Last Name SSN (see instructions) Dependent's relationship to you 7 • 7Senior: If you (or your spouse/RDP) are 65 or older, enter 1; if both are 65 or older, enter 2. See instructions ... 9 Total wages (federal Form W-2, box 16). See instructions. . . . . . . . . . . . . . . . . . . . . . • 9 10 Total interest income (federal Form 1099-INT, box 1). See instructions............ • 10 11 Total dividend income (federal Form 1099-DIV, box 1a). See instructions. ......... • 11 12 Total pension income See instructions. Taxable amount. ........... • 12 16 Add line 9, line 10, line 11, line 12, and line 13............................... • 16 17 Using the 2EZ Table for your filing status, enter the tax for the amount on line 16. Caution: If you checked the box on line 6, STOP . See instructions for completing the Dependent Tax Worksheet. ................................. 17 13 Total capital gains distributions from mutual funds (federal Form 1099-DIV, box 2a). See instructions. .............................................. • 13 18 Senior exemption: See instructions. If you are 65 or older and entered 1 in the box on line 7, enter $149. If you entered 2 in the box on line 7, enter $298. ........ 18 19 Nonrefundable renter's credit. See instructions. ............................. • 19 20 Credits. Add line 18 and line 19. ......................................... 20 21 Tax. Subtract line 20 from line 17. If zero or less, enter -0-. .................... • 21 22 Total tax withheld (federal Form W-2, box 17 or federal Form 1099-R, box 14). ..... • 22 23 a Earned Income Tax Credit (EITC). See instructions. ......................... • 23a b Young Child Tax Credit (YCTC). See instructions. ........................... • 23b 25 Total payments. Add line 22, line 23a, line 23b, and line 23c. .................. 25 . 00c Foster Youth Tax Credit (FYTC). See instructions............................ • 23c

3113243 Form 540 2EZ 2024 Side 3 ISR Penalty Code Amount California Seniors Special Fund. See instructions Alzheimer's Disease and Related Dementia Voluntary Tax Contribution Fund Rare and Endangered Species Preservation Voluntary Tax Contribution Program California Breast Cancer Research Voluntary Tax Contribution Fund. California Firefighters' Memorial Voluntary Tax Contribution Fund. Emergency Food for Families Voluntary Tax Contribution Fund. California Peace Officer Memorial Foundation Voluntary Tax Contribution Fund. California Sea Otter Voluntary Tax Contribution Fund. California Cancer Research Voluntary Tax Contribution Fund. School Supplies for Homeless Children Voluntary Tax Contribution Fund State Parks Protection Fund/Parks Pass Purchase Protect Our Coast and Oceans Voluntary Tax Contribution Fund Keep Arts in Schools Voluntary Tax Contribution Fund. Overpaid Tax/Tax Due • • • • • • • • • • • • • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Contributions . 00 Individual Shared Responsibility (ISR) Penalty. See instructions ............... • 27 27 If you and your household had full-year health care coverage, check the box. See instructions. Medicare Part A or C coverage is qualifying health care coverage .............................. If you did not check the box, see instructions. 30 Payments after Individual Shared Responsibility Penalty. If line 28 is more than line 27, subtract line 27 from line 28. .................................... 30 33 Tax due. If line 30 is less than line 21, subtract line 30 from line 21. See instructions. .................................................... 33 28 Payments balance. If line 25 is more than line 26, subtract line 26 from line 25 . ... 28 29 Use Tax balance. If line 26 is more than line 25, subtract line 25 from line 26. .... 29 31 Individual Shared Responsibility Penalty balance. If line 27 is more than line 28, subtract line 28 from line 27. .......................................... 31 32 Overpaid tax. If line 30 is more than line 21, subtract line 21 from line 30. ........ • 32 • Prevention of Animal Homelessness and Cruelty Voluntary Tax Contribution Fund California Senior Citizen Advocacy Voluntary Tax Contribution Fund Native California Wildlife Rehabilitation Voluntary Tax Contribution Fund • • • . . . . . . . . . . . . . . . . . . . . . . . . . . .

333Side 4 Form 540 2EZ 2024 Type Type AMOUNT YOU OWE. Add line 29, line 31, line 33, and line 34. See instructions. Do not send cash. Mail to: FRANCHISE TAX BOARD PO BOX 942867 SACRAMENTO CA 94267-0001 REFUND OR NO AMOUNT DUE. Subtract line 34 from line 32. See instructions. Mail to: FRANCHISE TAX BOARD PO BOX 942840 SACRAMENTO CA 94240-0001 Pay online - Go to ftb.ca.gov/pay for more information. 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. Have you verified the routing and account numbers? Use whole dollars only. All or the following amount of my refund (line 36) is authorized for direct deposit into the account shown below: Routing number Checking Checking Savings Savings Account number 37 Direct deposit amount The remaining amount of my refund (line 36) is authorized for direct deposit into the account shown below: Routing number Account number 38 Direct deposit amount Amount You Owe Health Care Coverage Info. Direct Deposit (Refund Only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • • • • • • • • • • • . . . . . . . . 34Add amounts in code 400 through code 447. This is your total contribution34 . 00 Contributions For voter registration information, check the box and go to sos.ca.gov/elections. See instructions ................... Do you want information on no-cost or low-cost health care coverage? By checking the "Yes" box, you authorize the FTB to share limited information from your tax return with Covered California. See instructions ............................. Voter Info. • • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mental Health Crisis Prevention Voluntary Tax Contribution Fund California ALS Research Network Voluntary Tax Contribution Fund Sign Your Tax Return on Side 5 Ye s No

3115243 Form 540 2EZ 2024 Side 5 Our privacy notice can be found in annual tax booklets or online. Go to ftb.ca.gov/privacy to learn about our privacy policy statement, or go to ftb.ca.gov/forms and search for 1131 to locate FTB 1131 EN-SP , Franchise Tax Board Privacy Notice on Collection. To request this notice by mail, call 800.338.0505 and enter form code 948 when instructed. Under penalties of perjury, I declare that, to the best of my knowledge and belief, the information on this tax return is true, correct, and complete. It is unlawful to forge a spouse's/RDP's signature. Joint tax return? See instructions. Y our signature Date Spouse's/RDP's signature (if a joint tax return, both must sign) Y our email address. Enter only one email address. Preferred phone number 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) Firm's address Print Third Party Designee's Name Telephone Number PTIN Firm's FEIN Do you want to allow another person to discuss this tax return with us? See instructions. Ye s No Sign Here • • . . .•