sieve California Nonresident or Part-Year 2021 Resident Income Tax Return CALIFORNIA FORMA API 102-31-4561 CORT 21 PBA 999999 MARIA D CORTAZAR A R RP 2503 FALCON KNOLL LN KATY TX 77494 01-1966 It your Calfomia fling status i ferent from your federal filing sttus, check the box here + Lx | single 4 Head of household (with qualifying person). See instructions Qualiying widewier). Enter year spouse/ROP died 2 |__| Mariea/ROP fing oimly See inst. 5 oO fame em] 2 |__| meriea0® tng separately Ener spouse's/ROP's SSN of TIN above and fullname here {5 It someone can cakm you (or you spouse/ROP) 28a dependent, check the box hee, See ist... @ 6 P Forine 7. Ine, ne 6 and ine 10 Mull the number you enlerin he box by the preted dolar amount orth ™ ne eae We tars ont 7 Personal: you creche box 1,3, 4 above, ener tin the box you checked bor Zor enter2 Ifyou checked the Bor online see nstuctons. @)7| 1 |x st20~@ s 129 8 Bind: you (or your spousesROP) ae visually impaired, enter itteth are vsualy epaied enter 2 @s|_]xsiz0- @s 9 Senior: Ifyou (or your spouselROP) are 6S or alder, enter ibe are 5 colder, enter 2. See insuctons os|_|xsiz0-@s 2 10 Dependents: Do not include yourself or your spouse/ROP. 2 Dependent Dependent 2 Dependent 3 EB Fimname © ® ® BT tasttane @ © ® 35H See inicio @ ° ° Dependents resvorshi @ ® © ew xsioo= © s ‘otal cependent exemptions a 098 3131214 c Form S40NR 2021 Sidet iYour name: MARIA D_CORTAZAR Your SSNoriTIN [102-31- 4561 11 Exemption amount: Add line 7 through line 10 Ous 129 12. Total California wages trom your federal Fors) W.2, box 18 en 20,302 413. Enter federal AGI from federal Form 1040, 1040-SR, or 1O40.NR, line 11 On 59,443) od £ 14 Cattoma adjustments subtractions, Ener the amount om Schedule CA (S40NR), § Part tne 27, column B eu fod] 45 sunractine 14 from ine 13. tins han sooner he ent parentheses J $ See instructions rH 59,443] 0 $16 Calforia adjustments - addons Enter the amount fom Schedule CA (40NR), Par I, bd Fine 27, column ¢ ow lo: 3 3 © 17 Adjusted gross income trom al sources. Combine ine 15 and line 16 ew 59,443] .[od 18 Enter the larger of Your California Itemized deductions from Schedule CA(540NR. Partll ine 30; OR Your Calforma standard deduction, See instructions ew 4,803) «lod 19 Subtract ine 18 trom line 17. This is your total taxable income, fis than zero, enter 0. @ 54,640] lo X |Tax Table Tax Rate Schedule 31 Tax Check he boxif rom e|__|rre3s00 |_| Fre 3003 on 2,166] od 32 CAadjustes gross income trom Schedule CA (S4ONR), Part Vine 1 ex 20,302] fod 35. CATaxable Income from Schedule CA (S40NR), Part IV, tne 5 o3s 18, 662] .od e 2 3 ‘36 CATax Rate. Divide line 31 by line 19 ©s6 | 0.0396) 37 CATaxBefore Exemption Credits. Mutiply ine 35 by ine 36 @v 739] E38 CA Exemption Crest Percentage, Divie line 35 byline 18. S ——ttrmore than 1, enter 1.0000 @w [0.3415 39 CAProrates Exemption Crests, Multiply lin 11 byline 38 ifthe smounton ine 13 is more than $212,286, see instructions ox» 44] bd 40 CAReguiarTax Before Credits. Subtract tne 39 from ine 37, Iles than zero, enter-0- @ 40 695] bd 41 wseenmcors Ceanetortion —@|_]sereauecs @[_|rrBss700 @ 41 bd 42. Addie 40 andiine 1. ew 695] bd 150 Nonvefundable Child and Oependent Care Expenses Credt. See instructions. Atach frm FT 3506 ie es od 51 Credit fr joint custody head of household 2 See instructions ost lo 3 2 S52 creat for dependent parent See instructions ..@ 52 -lo % 53. crect forseniorhesd of household go ote ate od ® 54 credit percentage. Enter the amount fom tne 38 here If more than 1, enter 1.0000. See instructions Ou 85 Credit amount. See instuctons Da rr @ 6 [D_ Side 2 Form 540NR 2027 098 3132214 aYou name ARIA D_CORTAZAR our SsNor Tn i02-31-4561 58 Ener credtnane code @{__land amount so od 2 59. tnercrestrame code @|__Jand amount os tod 3 60 Tocdeimmore han wo ered, See latutons ed 2 5B 61 Nowetundable Renter's Cred. See Instructions en od & 62 Add line 50 and line §5 through 61. These are your total credits. @s +0. 63 Subtract line 62 from line 42. If less than zero, enter -0- os 695) bd 71 Altemative Minimum Tax. Attach Schedule P (540NR) en 0 vx: act int Oc tn enc en bd s Er one esensceaesg Stanton en bd 74 excess Advance ream Asn Sis APA) payment ees... @ 74 bed 75. Add ine 69,08 71, ie 72, 73, and te 74. This your total tx or 695) bd at on 44) lod 82 2021 CAestinated tax and other payments, See instructions en 83. witnolsing (Form $92.8 andor 583). See instructions ons © e4 Excess SOI (or VPON withheld. See instructions on E85 eames income Tax Creat (EITC) ons 85 Young Child Tax Credit (YCTC), See instructions 08 87 _ Net Premium Assistance Subsidy (PAS), See instructions en 88 Add line 81 through line 87. These are your total payments. See instructions Ow 484) [B91 It you and your househols ha fulkyear neath cae coverage, check the box See instructions. Medicare Part Aor C coverage is qualying heath care coverage ° E _ttyoudid not check the box, see instructions. % Individual Shared Responstilty (SR) Penalty See instructions on @ 82. Payments afer Individual Shared Responsibility Pena Iline 68 is more than line &1 subtract ine $1 from ine 68 ve O82 484) fod % 93 Individual Shared Responsibility Penalty Balance. If line 91 is more than line 88, subtract line 88 from line 81 @xs fod £ 2 101 Overpaid tax. fine 92 's more than line 75, subtract ine 75 trom ine 82 Ow fod E 102 Amount ottine 101 you want apoio to your 202 estate tax © 102 fod a ose! = 3133214 Form S40NR 2021 Side 3Yourname ARIA D_CORTAZAR Your SSN or TIN: [102-321-4561 103 Overpaid tox a ble thi year. Subtract line 102 fom line 101, 104 Tax dve. If line 92s loss than line 75, subtract ine 92 trom line 75 Calfomia Seniors Special Fund. See instructions Caltomia Sea Otter Voluntary Tax Contribution Fund Cnt State Parks Protection Fund Parks Pass Purchase Keep Ants in Schools Voluntary Tax Contibution Fund Rape kit Backlog Voluntary Tax Contribution Fund ‘Schools Not Prisons Voluntary Tax Contribution Fund ‘Suicide Prevention Voluntary Tax Cortrbution Fund [Sides Form 540nR 2027 O59 ‘Azheier’s Disease and Related Dementia Voluntary Tx Contribution Fund Rare and Endangered Species Preservation Voluntary Tax Contribution Program Caiformia Breast Cancer Research Voluntary Tax Contribution Fund Calta Firefighters Memorial Vountary Tax Contibuton Fund Emergency Food for Familes Voluntary Tax Contribution Fund California Peace Officer Memoria! Foundation Voluntary Tax Contribution Fund Califomia Cancer Research Voluntary Tax Contribution Fund ‘School Supplies for Homeless Children Voluntary Tax Cantributon Fund Protect Our Coast and Oceans Voluntary Tax Contribution Fund Prevention of Animal Homelessness and Cruelty Voluntary Tax Contribution Fund CCalfomia Senior Citizen Advocacy Voluntary Tax Contibution Fund Native California Wife Rehabiltation Voluntary Tax Contribution Fund ‘Mental Hesith Criss Prevention Voluntary Tax Contribution Fund CCalfomia Community and Neighborhood Tree Voluntary Tax Contribution Fund 120 Add code 400 through code 446, Ths is your total contribution 3134214 © 0 ed © 10 ail} fo Code Amount © 400 @ 401 [0 @ 403 {0 © 405 (0 © 406 0 o «07 bod o 4 bd © «0 bod oun bd ean bd oa bd ou bd oa bd © 431 lod © 4s © 430 © 40 o 43 rd o 4s o 46 © 120 i 23Yourname [MARIA D_CORTAZAR Your SSN or TIN hoz-31-4561 §§ 121_amount you owe, Ai ine 93. ne 104, and ne 120 See nsructons De net send cat, £3 __Mallo FRANCHISE TAX BOARD, PO BOX 942867, SACRAMENTO CA 94267-0001 @ 121 21 fo <2 _ Pay ning = Goto Rb. gov'pay for mere ifomaten py 122 Interest late retum penaties, and late payment pansies 121 Eg 123. Underpayment of estates tax e: BE Checrthebor @|_} FTE 5806 atached @|_| Fr 5805F attached o 1 124 Total amount due. See instructions, Enclose, but donot staple, any payment 124 21 ‘25 REFUND OR NO ANOUNT DUE, Subic Ine 120 om ne 103 Sea WaOcIOTe Mall FRANCHISE TAX BOARD, PO BOX 942840, SACRAMENTO CA 94240-0001 @ 128 Fitin the information to authorize direct depos of your refund int one or wo accounts. Do not ata a voided check ora depos See instructions, Have you verified the routing and aecount numbers? Use whole dors only [___Mortetotonng anout omy ting 25) authorize fr et pesto te acai shawn bow 3 ° (© Routing number cout 126 Direct deposit ameun t etoaunter [| csenng ACU UnbeL o pa z |_| savings E _Terenaiang amount of my reins ne 125) authorized fr drt depost into the account shown below ype outing sumer 127 Diet éepost amour Routing umber hese ne be ed Savings IMPORTANT, Atach a Copy f your complete fedora ret (er Brac sc an Be ain alta Dood eerie Gold MDa Gorpay Ho osn BOU wu Paypal Salve gow Ra goto Bod wa TST [loa FTS 1131 EXE Franch Tax Bad Privacy Noe on Colecon To request i ate by ma cal 60338 0805 and rer code S48 when ruc Under penalties of peru declare that | have examined ths tax return, incuding secompanying schedules snowiedge and beets tue, comect_and complete, nd slatoments, and tothe Best of my nose oa See URDP iran ol ar (Q verano Ene 0 ents Suan Sign _MARIACORTAZARS4@GNATL..cOM le32-762-0901 Here sensu sane declaration of preparers based onal information of which propre has any tnowedge) SANDRA L GALLEGO phere Firm's name ir 1 set-errployed) @ ot soos — (sy muutrseevrce INC fpoxa0eiz2 i © cane ane 6613 CHIMNEY ROCK HOUSTON TX 77081-5305 90-0076029 as parte pac meow ba tm pan gee soy cl] tage a peta Ones are sass a 098 3135214 “Form S40NR 2027 sides00791311 DO NOT MAIL THIS FORM TO THE FTB 2021 California e-file Signature Authorization for Individuals 8879 or Sonor MARIA D CORTAZAR Spowe wROPe rare 02-31-4561 Spewse'aROP' SSN or TW Part Tax Return Information (whole dolars ony) 41 Calforia adjusted goss income (AGI). See instructions 1 20,302. 2 Amount You Owe. See instructions 2 211. '3_Retfund or No Amount Due. See instructions 3 Partit_Taxpayer Declaration and Signature Authorization (Be ne you oben and hep a copy your roure) Unde nai opera, Idee at have exaried a coy my iva eae lax lun ad accompanying schedves and atone ak year ending December 31,2021, ant the best tm knowege an bel, ue, ced andconpeta. futher Gelartal ie irlornan | povided tomy letoncretom ont (ERO), ansmt, Freres seven prover, ncdeg my nae, adres, and cil ect number (SSN) oni ‘ax enficaten number (TIN. and he amos shown in Pat above age whe ean and anouts show othe corespordng Ines of my econ Income tax retun. apa, | auhonzeaneecrnic nds wihraval the anout on ne 2 andr he estimated tax payers as shown on my retun {don fom FTB EAS, Calflomia fle Payment Recaro indivi, ra corparaie form apical, | ecarehat dre epost lund anourton ie 3 ‘agrees with the ec epost autora slated on my ret Rave ed ant tum, ie is an evocable appnimant of oer spouseegstere domes parr (ROP as an agento authorize an lecon ids wihdranal rect epeal atexize my ERO, vara, ileedateSvce prover to tansy compete retum oto Frnchise Tax Boa (FB) the processing omy eur or rend Is delayed, author te FTB to sclose tomy ERO, intermeciat service provider, andlor ransmiter the reason(s) for the delay the date when the refund was sent a nga lance due re, | undestnghati he FT des notreceve fl ard ely tayrent fy tae abit ean al rth tax ally an al appicabl ees and pens. | _chrowiedge that hav ea and cnet othe Becton Funds Wal Consort en the copy of my elo ncome tx ren Ihave selected a ‘Personal dntiiaon number PIN) a8 y hare omy elector nce a tum and appeal, my Elec Funds Windraval Consent ‘Taxpayer PIN: check one box only 'autnonze JT_MULTISERVICE INC to enter my Pin [11.966 ERO frm ame ‘Do not ent all eros {8 my signature on my 2021 e-fied California individual income tax return, 7 tw eoter my Pan as my signature on my 2021 e-fled Calforia individual income taxreturn. Check this box only if you ae entering your ‘oun PIN and your retum is ed using the Practtener PIN method. The ERO must complete Pat lt below Yeorvonanee > ome» 03/22/2022 Spouse sROP' PI check ne box ely Ll testers, toenter my PN Roa Sentai a ros 12 my signature on my 2021 e-fied California individual income tax return [1] tweeter my Pat my sate ony 221 ele Caton coe tx retam, Check hs ox ony yu se ering your fom PIN an our rtm ed ang the Practoner PIN method. The ERO mu complete Pat I below ‘Spouse'sROP's signature at Pracitoner PIN Matiod Returns Only ~ continue below Par ll_Cenifieation and Authentication — Practitioner PIN Method Only [ERO’s Electronic Filer Identification Number (EFIN) PIN. f9131176029 Enter your sx-cigt EFIN followed by your fve-sigtsel'selected PIN. ‘Bo net enteral zaree | ceity thatthe above numer erry is my PIN, which is my signature fr the 2021 Calfornaindvdual income tx return for he taxpayers) indicateg above | confirm that | am submiting this retur in accordance with he requtements ofthe Pracitoner PIN method and FTB Pub 41345, 2021 Handbook for Authorized e-file Provides. ERO's signature» SANDRA _L_ GALLEGO bate » 03/22/2022 For Privacy Notice, et FTB 1131 EN-SP. FTB 68792021Voucher at bottom of page. a DO NOT MAIL A PAPER COPY OF YOUR TAX RETURN WITH THE PAYMENT VOUCHER. amount of payment is zoro, do not mail this voucher. WHERE TO FILE: Using black or biue ink, make your check or money order payable to the "Franchise Tax Board.” Write the taxpayer's social security ‘number (SSN) or individual taxpayer identification number (ITIN) ‘and "2021 FTB 3582" on the check or money order. Detach the voucher below. Enclose, but do not staple, payment with the voucher and mail to FRANCHISE TAX BOARD PO BOX 942867 SACRAMENTO CA 94267-0008 ‘Make all checks or money orders payable in U.S. dollars and drawn against a USS. financial institution WHEN TO FILE: Calendar Year - File and pay by April 18, 2022. ‘When the due date falls on a weekend or holiday, the deadline to file and pay without penalty is extended to the next business day. ONLINE SERVICES: Use Web Pay and enjoy the ease of our free online payment service. Go to ftb.ca.gov/pay for more information Do not mail this voucher if you use Web Pay. DeMCHHERE__ _IF NO PAYMENT IS DUE, DO NOT MAIL THIS VOUCHER ‘CAUTION: You may be requred to pay electronical. See instructions, wusicves Payment Voucher for ‘cauromwa Fon 2021__ Individual e-filed Returns 02-31-4561 CORT 21 MARIA D CORTAZAR 2503 FALCON KNOLL LN KATY TX 77494 Amount of payment aun. [ere ns 098 1251216 F168 3562 2027 ill“= California Adjustments — SCHEDULE 2021__Nonresidents or Part-Year Residents CA (540NR) Taportant Also ie schetve behind Fam MARIA D CORTAZAR It |__Residency Information. Complete all lines that a During 2021 1 My Calitomia (CA) Residency (Check one) 4 Mysett @X_Nowesdet @___Par-Yar Resitnt © __Resien 2 a was domicile in (enter two letter code, see instructions) PPly to you and your spouse/RDP for taxable je 5 as a supporting Calfomia schedule, Yourself SSNorTN 102-3 72021, 1-4561 b Spouse: © __Nonesdent @ __Par-YearResdert @)__Resident SpousemROP. ™ © 1 | was inthe mitary and stationed in (enter two letter code) © =O) — 3 | Decame a CA resident (enter state of prior residence and date (mmiddyyy) of move)... @ ® |Decame 2 CA nonresident (enter new state of residence and date (mmidyyyy) cf move). @) @ 5 Iwas @ CA nonresident the entre year (enter state of residence) ® —cA @ 6 The number of days | spentin CA for any purpose was © © 7 owned a homelproperty in CA enter ¥ for Yes, N fr No} ® @ 8 Before 2021: | was a CA resident forthe period of ® - @ © © Partll_ Income Adjustment Schedule a e a Dy E Section — Income Federal Amounts | Subactons | __Adaitons | TotarAmounts | CA Amounts from federal Form 10400r 1040-SR _|twxablearounis ron} Seeinstuctens | Seeinsiuctens | Using CALaw | (acore eared or yourfeseraltaxietun] (aterence beeen | (aterence between | Astt¥ou Were | feceied as aA CABtederainw) | “CABTederliow) |" CAResident |resdent and income {subractol 8 tom | eames or received Col A 208 col © | tom CA sources tothe eau | ab aronrescent) 1 Wages, salaries, tps, ete See instructions before making an entry in col. B or © 1 @_ 20,302 lo 20,302 |@ 20,302, 2 Taxable inerest. 2 ©, 2» © fo © 3 Ordinary dividends. See instructions. 8 Oz sen, 2 © © © 4 IRA distributions See instructions. © i= nw | wn 01 © lo 5 Pensions and annuities. See instructions, a @. sb |@ © © 6 Social secuty benefits a Ores ncn 6 o © lo ‘7.Capital gain or (oss). See instructions | je ‘Section B — Additional Income from federal Schedule 1 (Form 1040) 1 Taxable retunds, credits, or ofsets of state and local income taxes 1 lo 2a Airy received. See nstuctons 2l@ Io © © 3 Business income or (oes). See nstuctons.. 3 [Qa 7 1@ © Qa, © 4 Otner gains or (osses) 1 © 0 5 Rental real estat, royalties, prnersip, S coporaions, tsi, ec s | lo lo lo lo {6 Farm income o (loss) 6 |O lo oO [© [© 7 Unemployment compensation 710 lo TED rorrivacynotce,getrrerisiense 999 7741214 ‘Schedule CA(S40NR) 2021 Side Il‘A D CORTAZAR a 102-31-4561 a 8 c D E ‘Section B= Kaaiional Income eae Ansan | —Subtractons | Adaitona —| Tota Amounts | —CRAmounte Continued (ate amoinston | seeinsrvctons | See nstnctons | Using eataw | (ocome eames o Yourlecraltar ru) |(amerence between} (Aterence between | As lf¥ouWerea | received as aCA CAB ederallaw) | CAR federallaw) | CAResident — | resident ard income (subtract cot B trom | eared or received eal A: add cal | tomCA sources totheresut) | #8. nonvesiden) 8 Other income: Federal net operating loss ta ) 1] g Genbing exe = 8 @ ie S © Cancellation of debt ac [O_ © fo © 4 Foreign eared income exclusion trom federal Form 2585 va (© lo © (2 © Taxable Heath Savings Account distribution so |© Oo 1 Aiaska Permanent Fund dividends at (OD io Io 9 Jury duty pay 8% | © 2 Prizes and awards sn © © 2 1 Activity not engaged in for proft inco si (@) 1. Q J Stock options: 3 © {O} © income trom the real of personal property i you engaged in the rental for Profit but were notin the business of © ranting wuch rope « © lo 1 Olympic and Paralympic medals and USOC prize money a @ o_ 1 m__ IRC Section 951(a) inclusion am |© 18 IRCSecton 951A(a) incision... 8m [® © IRC Section 461() excess business > lo loss adjustment 8o © © Taxable distributions trom an ABLE account » © © o. Other income, List ype and amount a lo lo © o 9 a Total other income. Add ines 6a through 8 oa lo lo © \o bt Disaster oss deduction form FTB 3¢05v st fo © © 2 NOL deduction fom form FTB 3805 sb2 © © O_ 3 NOL trom form FTB 38082, FTB 3807, or FTB 3809 9b3 © 10) © bb. Student oan discharged due to closure ofa for-proft school 94 | lo © ©. 10 Toa! Gentine Seah tnt test ine, Bec Secon tne ttheugnine 7. te ine ot eroug ine So (Os apples) mesh ‘column See instructons. Go to Section C 10 ® 62,419 © © © __ 62,419. |@__20, 302. Bosatsmaconm “sel aaa Co OlMARIA D_CORTAZAR 02-91-4561 x 3 c D E Section € — Agjustments to Income eal haan} —Sanenciona | Batons —| Tort Amounts] — ERA trom feeral Schedule 1 (Form 1040) | aale ances tom | See ratucere | Seeranens | Uung caLAw | (ncone eed or youre! en | serene tetacn | (ctererca betwen | Axio Were | vecored asa CA (CABTedeain) | (CAS sea inn)” | “CA Reaient | renicrt and income ‘rom casos Ty Educator exponen w 12 Certain business expenses of reservists, fe bev ant te ee Sasa sovenment ofan 2 © 2 13, Heath savogsaccuntdeducten 13 14 Movng emenves Atach fmm PTB 3813 See vctors “ © 18 Desvable pat of eemploymet tax Ste nstctore ‘8 2.07 (© 2.976 16. Setempiyed SEP, SIMPLE and ‘ilies pans ‘6 17 Setenplayed oath nerancedecton See marion ” © oe 18 Penaity on eary wihdrawalof savings. 18 182 Almony paid. b Enter recipients © |G Woo Woe. ssw ©, Last name ©. 194] 20. IRAdeducton 20 21 Student loan intrest deduction a 22. Reserved for ture use 2 23. Archer MSA deduction 23/0. 24 Other adjustments: 2 4s 08y pay 2001 : Denti epee eae reper om er peor pepery eget on 20) 1) Ip € Nortmable mou ev Oympe and Parmer USOC pean reney toe et 4 Retreenton orozaten aa © Reema ose “engine art une ade near a 1 comvteno ke Secon 019610) persion ans. 2 1 Conretenstycotanapansto In Seton 490) prs 24) hh Atoney essa cutee sco nctng coal Gjecmiten cire 2 1 Atrey esa coutons you rs tnesmecton wih on avr ome IRS romain you roves at nepedtne ceetaiaw vats... 24 (9) | owing eeicton tom ee Fem 2555 4® cee dette ct RG Seton 76) taoese ede Seal Kt ‘Fo 24) au 2. Onerasianens Ust ye en anout 7 x © © 9 WD wer eer me 000] saa2 Schedule CA(GAONR) 2021 Sides Al TIO e joo oc Ce Per pee Pele Io (Oo & = SC CPP wf oO |e Io (oO o Coe © oo © feMARIA _D_CORTAZAR 102-31-4561 A c D E Section C — ‘Aalustmenta: to Income ‘ederal Amounts Subtractions | ‘Additions Total Amounts: ‘CAAmounts ntinued (arable amounts tom See nsructons | seeinstuctons | Using Ga Law | (ncome eamed or Your federal tax tu) | (aierence between | (aiterence between | AsttYouwerea | received ss aCA CAN ederalian) | CAR tederalinw) | “CAResident | resident and income (euract cot rom | eamed or received ‘co A adscol | tomCA sources, Tomeresut) | a8 8 nonescert) 25 Total other adjustments, Add lines 24a through 24z aa le le lo lo 26 Addline 11 through line 23 and line 25 iin each Column, A through E . 26 2,976 |© © © __2.976.|© 27 Total. Subtract line 26 from line 10 in each Column, through E. See instructions. 27 59,443, © 59,443. © 20,302 Crane any OF ena ge came Check the box if you did NOT itemize for feder I but will itemize for California [Form 1040) Medical and Dental Expenses See instructions 1) Mecical and dental expenses © 7 2 Enter amount from federal Form 1040 or 1040-SR, line 11 .. .© | 3° Muttiply line 2 by 7.5% (0.075) © 3 4 Subtract line 3 from line 1, I tine 3 is more than line 1, enter 41 fo Taxes You Paid Sa_ State and local income tax or general sales taxes, Sal 484. 484 | Sb State and local real estate taxes so|© Sc State and local personal property taxes 5e(@ 5d. Add line 5a through line Se 5 casted RR ve 5d\@ 404, Se Enter the smaller of ine 54 or $10,000 ($5,000 i marie fing separately) in column A Enter the amount from line 5a, column B in line Se, column B . . aoa Enter the difference from line 5d and line 5e, column A in line 5e, column C 5e| 484. A S 6 Other taxes. List type ©, 4 55 ar mal®) 7__Add line Se and line 6 Interest You Paid 6 ‘8a Home mortgage interest and points reported to you on federal Form 1098 29 g © 8b Home mortgage interest not reported to you on federal Form 1098 8b] © 8c Points not reported to you on federal Form 1098 8 g iS 8d Mortgage insurance premiums eel ©. (0) Be Add line 8a through line 8d ‘3 S iS 9 Investment interest 28 S 2 40_ Add ine Be and line 8 Gifts to Charity a © 6 41 Gifts by cash or check te io © 12 Other than by cash or check ie 413 Carryover from prior year © I® © 14 Add line 11 through ine 13 1O {} {O} Casualty and Theft Losses 15. Casualty or theft loss(es) (other than net qualified disaster losses). lb - lo ‘Attach federal Form 4684, See instructions 15 Other ltemized Deductions 5 federal instructions, S 16 in columns A, B, and C 18 Total. Combine line 17 column A less column B plus column C... . [EE sides schedule Ca(640NR) 2021 “99 1 7744214MARIA D_CORTAZAR Job Expenses and Certain Miscellaneous Deductions 19 Unreimbursed employee es pense’ - job travel, union dues, job education, 102-31-4562 ete Atach federal Fam 2108 Frequned See oe Ow 20 Tax preparation fees. On 21 Oberexperses:ivestrant sae deca boxe Lattype © On 22 Add line 19 through line 21 On 23. Enter ancant om federal Fom 1040 10058, re 11 @ 24 Mutipty tne 23 by 2% (0.02). tes than zero, enter 0 Ou 25 Subtract line 24 trom line 22. If line 24 is more than line 22, enter 0 Ow 26 Total Itemized Deductions. Add line 18 and line 25. On 27 Oneradgninec, Se enon. pect. ©. oF 28 Combine line 26 and line 27. ae 28 _ Is your federal AGI (Form S40NR, line 13) more than the amount shown below for your filing status? ‘gl ot mariedROP fing seperately sarazee read of ovat 8437 MariegROP fing jit or uahing women sant No. Tasterte amout on ine 2 tine 22 Yes. Conte tenes Deco Vbttet hie mstuctens Sead cat} re 28........ 20[__ 30 Enterthe larger of the amount on line 29 or your standard deduction listed below cgi ormamedROP ng sepa See nstosions e002 MariedROP fig ont, head Reread, or quliyg wwe) ©xn[__«.203] PartV California Taxable Income 7 California AGI. Enter your California AGI from Part Il, line 27, column E Ot 20,302, 2. Enter your deductions trom ne 30... : 1.@2__ 4,803. 3 Deduction Percentage. Divide Pat ne 27, column Eby Par I, ine 27, column D. Cary the decimal to four places. If the result is greater than 1.0000, enter 1.0000. If less than zero, enter -O- Os 0.3415 4. California Kemized/Standard Deductions. Mutply tne 2 by the percentage online 9... ....0 +s Os § California Taxable Income. Subtract ie 4 fom ine 1. Transfer his amount to Form S4ONR, line 35, iless than Os zero, enter -0- | 0981 = 7745214 ‘Schedule CA(S40NR) 2021 Sides IlCALIFORNIA AMOUNTS Profit or Loss From Business ‘ (Sole Proprietorship) [> _Attach to Form 1040, 1040-SR, 1040.NR, or 1041 ‘Name of proprietor MARIA D CORTAZAR ‘A Principal business or Gi 0 to www.irs.gov/ScheduleC for instructions and the latest information. (OMB No_ 1845-0074 2021 Attachment ‘Social security number (SSN) 02-31-4561 profession, | MANAGER sion, including product or service (see instructions) 'B Enter code from instructions 999 c Business name. if no separate business name, leave blank te busi ane separate business name, leave bla oT ah Business address (including suite or room no) City, town or post office, state, and ZIP code Aecount = ts oe (EJ cash (aL Jacowat (3) [J otner (specify) > ; lally participate’ in the operation of this business during 20217 If "No," see instructions for limit on losses You started or acquired this business during 2021, check here ous you make any payments in 2021 that would require you to file Form(s) 10997 See instructions. If "Yes," did you or will you file required Form(s) 10997 e-zon7 Income 1 Gross receipts or sales. See instructions for line 1 and check the box i this income was reported to you ‘on Form W-2 and the “Statutory employee” box on that form was checked > 1 2 Retums and allowances 2 3 Subtract line 2 trom tine 1 3 4 Cost of goods sold (trom line 42) 4 5 Gross profit. Subtract line 4 from line 3 5 & Other income, incuding federal and state gasoline o fel ox ced or refund (see insivcions) - . . [| 7__Gross income. Add lines 5 and 6 geiley Expenses. Enter expenses for business use of your home only on line 30. 8 Advertsing 8 18 Office expense (see instructions). [_ 18 8 Car and truck expenses (see 19° Pension and profit-sharing plans | 19 instructions) 8 20 Rent or lease (see instructions) 10 Commissions andfees . . {10 a Vebiles, machinery andequpment . | 20a 414 Contact labor (se insructons) rn b Other business property 206 12 Depletion 42 21 Repairs and maintenance . . | 24 13, Dercton and scion 178 22. Supplies (not included in Part ly [_22 ouedh rein ioe 23. Taxes and licenses 2 [23 instructions) 43 24 Travel and meals: ¢ 14 Employee benefit programs a Travel. 2a (other than on line 19) 14 b Deductible meals (see 15 Insurance (other then health). [48 instructions) 24b 16 _ Interest (see instructions): 25 utities 25 ‘a Mortgage (paid to banks, etc.) | 16a. 26 oes fess employment reds) 26 b Other 460 27a Other expenses (from line 48). [ 27a 17 Uslendrtssinalsenices [17 b_ Reserved for future use . 27 28 Total expenses before expenses for business use of home, Add lines 8 through 272 . 28 29 Tentative profit or (loss). Subtract line 26 fromline 7. . ‘ 29 42,117. 30 Expenses for business use of your home. Do not report these expenses elsewhere. Atach Form 8829 Unless using the simpitied 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 online 30 30 31 Net profit or (loss). Subtract line 30 from line 28. + If profit, enter on both Schedule 1 (Form 1040), line 3, and on Schedule SE, line 2. (Ifyou checked the box on ine 1, see instructions). Estates and trusts, enter on Form 1044, line 3. 3 42,117. + Ifaloss, you must go to line 32. 32 Ifyou have a loss, check the box that describes your investment in this activity. See instructions. + Ifyou checked 32a, enter the loss on both Schedule 1 (Form 1040), line 3, and on Schedule 32a] Alivestments at risk SE, line 2. (f you checked the box on line 1, see the ine 31 instructions.) Estates and trusts, enter on 32b [_] Some investment is Form 1041, line 3. « Ifyou checked 32b, you must attach Form 6198. Your loss may be limited. For Paperwork Reduction Act Notice, see the separate instructions. aca not at risk. ‘Schedule C (Form 1040) 202uate ay Te207 1e201 ver coroz ver zotoz vO. “uatK eaeas eobem 3s exeotpaH eaeas Tz0z - zoeoz sev coer sep vola 9 "uaTM yerapea sdoast TrvLga 2-4 zotoz zoeoz sobem, ssozp LTOBLO¥-S¥ AUIS ONTAAVIS "TIEMLAVHD xofkotdua,