ip) “~ a ~ ¥ a . be ( 1 ; sy . . . ~ , a ! ts Nae U 5 § c) q B d iva d wa i U.S. Troqsytpe opine Revenue Service yay) shea : 3 of . cm: . » oa |, a . Ne ‘pe fl ncome Ta A R e t Rh.8 FB sar‘the yebr January 1-December 31, 1967, { if _ or other taxable year beginning i... |. 1967, efiding . } secheseeeey 19 .ccercee et re First namo and initial (if joint return, use first names and middle initials of both) Last ‘name Your social security number _ Q ; S Damuc\ an £ Home address (Number and street or rural route) 2 pee : 8 City, town or post office, vaste : ZIP code a . no is : ; Enter below name dnd address used on your return for 1966 (if same as above, write ‘‘Same’’). If none filed, give reason. if changing from saparate to joint or joint to separate returns, enter 1966 names and addresses. ; pele Spouse’s present employer and address, : Your Filing Status—check only one: Your Exemptions Regular 6Sorover ‘Blind enter : . C “ la (2. Single . 2a Yourself . . - oO | or base n Ib Married filing joint return (even if only one had income) | 2b Spouse . + + -O OO .J checked &| 2-4: net ic ( Married filing separately. If spouse is also filing a returi, | 3a First names of your dependent children fo ‘= gnter tier (his) social security number in space provided abeve you. ECE Le IBICAGD sircsrsercressssestscsesvinniossenesceetnl and give first nama here ccceauaduusvasaeneesseenecennssossateneseDancananse ELLE. veccarl OMT wrvesrssceresererens id (] Unmarried Head of Household 3b Number of other dependents (from page 2, Part t, line 3 te ©) Surviving widow(er) with dependent child 14 Total exemptions claimed... + . oa 3 income 5 Wages, salaries, tips, etc. If not shown on attached Forms W-2 attach explanation |5 ; 5 1 et ade 6 Other income (from page 2, Part ll, line 8) 6 % all income |_7__ Total (add lines 5 and 6) : 7 of Both | 8 Adjustments to income (from page 2, Part Ill, line 5) : 8 my and wife | 9 Total income (subtract line 8 from line 7) ss ; 9 . Find tax 10 If'you do not itemize deductions and line 9 is less than $5,000, find your tax from |yg from table tables in instructions. Do not use lines lla, 'b,.c, or d. Enter tax on line 12. —OR— ’ lla If you itemize deductions, enter total from page 2, Part lV, line 17 , : If you do not itemize deductions, and line 9 is $5,000 or more enter the larger of: (1) 10 percent of line9; OR (2) $200 ($100 if married and filing separate return) >lla 1 elas , | : A : plus $100 for each exemption claimed on line 4, above a | ; : Hiniaven . Deduction under (1) or (2) limited to $1,000 ($500 if married and filing separately). rate J1b Subtract line lla from line 9 ; schedules lic Multiply total number of exemptions on line 4, above, by $600 Lid Subtract line.11c from liné 11b. Enter balance.on this line. (Figure your tax on this amount by using tax rate schedule On page 11 of instructions.) Enter tax on line 12. Picase attach Copy B of Fort V- 12 Tax (from either Tax Table, see line 10, or Tax Rate Schedule, see lines Lia-1id). ; 13. Total credits (from page 2, Part V, line 4) ; ae _ oo, L_Your . 14a Income tax (subtract line 13 from line 12) : ; , : : 14b Tax from recomputing prior year investment credit (attach statement) Ons 15 __ Self-employment tax (Schedule C-3 or F-1) a % and 1! "ye Total tax (add tines 14a, i4b, and 15) £ Pa 17 Total Federal income tax withheld (attach Forms W-2) 5 Fay: 18 Excess F.I.C.A. tax withheld (two or more employers—see page 5 of instr.) ments 19 (Cl Nonhighway Federal gasoline tax—Form 4136, (3 Reg. lnv.—Form 2439 19 20 1967 Estimated tax payments (include 1966 ovarpayment allowed as a Credit) 21 Total (add lines 17, 18, 19, and 20) 22 \f payments (line 21) are less than tax (line 16); enter Balance Due. | Pay in full with this return lan ; : = ea or 23 «If payments (line 21) are jarger than tax (line 16), enter Overpayment . Refund “24 Amount of line 23 you wish credited to 1968 Estimated Tax . 25 Subtract line 24 from 23. Apply to: [7 U.S. Savings Bonds, with excess refunded or Urider penalties of perjury, | declare that I' have examined this return, Including, accompanying schedules and statem trua, correct, and complete, If prepared by a person other then taxpayer, his declaration is based on all Information of which he has any knowledge., attach Check or Moncy Orde’ nts, and to the best of my wa and bolief it is © Cton ds . ; . ‘eo, . oe clad sezef g sign i? Your FT oe Cate D saat Feber jar aa ikpyst iw 7 bee Oe : J deaneantsne ZIM, AD isd sda Pan Met = : Address j 389—10—70800"2 so here ; seat aigaatate (lng jalntly; BOTH mia len evan WF only oe ad income) 55923, Docld:32245535 Page 167
_ * - SCHEDULE. D - Gains and Losses From Sales or Exchanges | Internal Revenue Service Attach this schedule to your income tax return, Form 1040 Pg Kind of prop act a vipasis, cost of b. Description quired, aes moe ected | estas 10m ot | Enter | 08M | owu sole | 4, crn en | F,Derctation | atest mpve: |, cain rt _ estas or other ee ory brick, | mbal | (mo., day, yr.) (mo., day, ye) . price allowable) since purchased, attach (t plus g less h) .. “ pecify) |. (Sea . acquisition . explanation) and instr.) . expense of sale Se i a setae wee [-Pike. Cos “9 Enter your share of net short: term gain (or loss) from partnerships and fiduciaries oo oes we ee a it 3 Enter unused, ‘short term capital loss carryover from preceding taxable years (attach . statement) « 8 8 ew 8 Mpa con AP Nat short-term gain (or loss), from lines 1, 2; and 3 . Total long: term gross sales price. 6 Enter the full amount of your share of net long-term gain (or loss) from partnerships and fiduciaries «6 5 oo frreenneeennn-penennenns 7 Enter unused long-term capital loss carryover from preceding. taxabie years (attach statement) . . 2 ew oe : vevccceeeeeseceanennes 8 Capital gain dividends (see Form 1040 Instructions, page 6). 2 ee ee ee we ee 9 Net long-term: gain (or loss) from lines 5,6,7,and8. 6. 6 6 6 we ee ee ee ee ee ee ) Combine the amounts shown on lines 4 and 9, and enter the net gain (or: loss) here . ot 11 ff line 10 shows a GAIN—Enter 50% of line 9 or 50% of line 10, whichever is smaller. (Enter zero if there is a loss or no , entry on line:9.) (See reverse side ‘for computation of alternative tax). 2 6 ew ee ee , 12 Subtract line 11 from line 10. Enter here and in Part IV; line l,‘ on reverse side, 2. . we ew oe ew we 13 If line 10 shows a Loss—Enter here and in Part IV, line 1, the smallest of the following: (a) the amount on line 10; (b) the amount on.page 1, line 11b, Form 1040, ‘computed without regard to capital gains and losses; -OF (c)- $1, 000. . « Part II—GAIN- FROM DISPOSITION OF DEPRECIABLE PROPERTY UNDER SECTIONS 1245 AND 1250— assets held more than 6 months (see instructions for definitions) ae ' Where double headings appear, use the first heading for section 1245 and the second heading for section 1250, nyt a. Kind of property and how acquired (if necessary, attach statement . e. Cost or other basis, cost of De yee of descriptive details not shown below—write 1245 or 1250 - b, Date acquired. c. Date sold d. Gross sales pri subsequent improvements (if uo eseriP - to indicate type of asset) (me., day, yt.) (mo., day, yr.) G. Gross sales price not purchased, attach wale nation) and expense of sale f. Depreciation allowed (or allowable) since acquisition _ g. Adjusted basis h. Total gai lesser of Por hi ———< $< ‘ed basi . Total gain. esser 0 f-1, Prior to January I, 1962 | f-2. After December 31, 1961 C) joss sum of f-1 and f-2) (dlessg) 9 f= OR }. Pe ’ 2 Total ordinary gain. ‘Enter here and in Part IV, line 2, on reverse side. . « . « 3 Total other gain. Enter here and in Part |, line 5; however, if the gains do not exceed the losses when this amount Is combined with. other gains and losses from section 1231 property enter the total of column j in Part ill, line 1. . W-—T9725-1 | _ (Form 1040) 0) Gay ne U.S. Treasury Department of Property | 9g 67 TASS EWR Beg GB ee
‘oo. ne db Exclusion (see instructions). |......-..-- "92. 7 “1: Je Capital ‘gain distributions "Interest (list payers and amounts below) ; 2 Total interest income . . > . & Sale or exctiange of property. (attach Schedule D) . "8 TOTAL (add lines 1f, 2, 3, 4, 5, 6, and ae la. Gross dividends and other distributions on 1 stock st payers and amounts-—write (H), (W), QU), for stock held by husband, wife, ‘or Total line la (see page 6 of instructions). id Nontaxable distributions | {see page 6-0f instructions). en le Total (add. lines 1b, 1c, and 1d). if Taxable dividends (ine la less line le—. not less than zero) . oe eee Earnings from savings and joan assoc. and credit unions. Other interest anks, bonds, ir vole etc.) ayeceeeseneenees ness Ast Mat. nade ok Bi ncolacisssl, 3 Pensions and annuities, rents and royalties, part nerships, estatos or trusts, ‘etc, (attach Sch. B) . 4 Business Income or loss (attach Schedule c). 6 Farm income or loss (attach Schedule F) . Miscellaneous income (state nature and source) 7 Total miscellaneous income. . . . > Enter here and on page 1, line 6. 1 ‘Sick : pay” if included in line 5, page 1 (at- tach Form 2440 or other required statement) . 2 Moving expenses (attach Form 3903) . 3 Employee business expense (attach Form 2106 or other statement) . . 4 Payments by self-employed persons to res tlrement plans, etc. (attach Form 2950SE) . § TOTAL ADJUSTMENTS (lines 1 through are Enter here and on page l,ilme8S .-. is claimed on lina 3b, page 1 ® Relationship (c) Months lived in your | home. If born or died dur- ing yoar write ‘ “BY or “OD” . 1. One-half (but not more than $150) of ine :| 13, ‘Total contributions (add lines 10, 11, ‘S ee (itemize) . tr U.S. GOVERNMENT PRINTING OFFICE : :1957-—-O-260-001 sooner mapper + Form 1040—1967—Page 2 {ey Amount YOU furnished (f} Amount furnisheu- ae . OF dependent’ 3 suppor by OTHERS Includ- ed ‘ it 100% write: “AL! Ing dependent (d) Did depond- ent have Income of $500 or more? (Se itemized deductions—Use only If you donot use tax table or standard deduction. Medical and dental expense (not compensated by insurance or otherwis e)—-Attach itemized list. surance premiums for medical care . 2 Total cost of medicine and drugs . . - 3 Enter 1% of line 9, page 1 4 Subtract line 3 from line 2 (not less than zero) 5 Other medical, dental expenses (include balance of insurance premiums for medi- cal care not deductible online1) . . . v6 Total (addlines4and5) . . . « « * 7 Enter 3% of line9, pagel... s - 8 Subtract line 7 from line 6 (not less than zero) . Total (add lines 1 and 8). Contributions. —Cash—including checks, money orders, etc. gi (itemize), pageaccesennegzercconcee pyensssnarcesaccccesenqnossoncccccecosonssennssnssarsssscsens o get 10 Total cash contributions . ... «. - 11 Other than cash (see instructions for required, . statoment). Enter total of such items here . 12 Ca rryover from prior years (soo page 8 of Inst.) and 12—see instructions for limitation) > Taxes,—Real estate. . 6 1 8 ef ee "State and local gasoline... + . General tated tsea page 15 of Instructions) . State and localincome. . . . .'s Personal property rr a 14 Totaltaxes. 2°. . ee ts ee Interest expense. Home Mortgage woe 17 TOTAL DEDUCTIONS (add ines 9, 13, 14, 1, and 16). Enter hore and on page 1, {Ine 11a. > wid 7} Credits 1 Retirement income credit (Schedule B) . 2 Investment credit (Form 3468) . 13 Foreign tax credit (Form 1116). . yo. a 4 TOTAL CREDITS (for page 1, line 13). © EXPENSE ACCOUNTS—If you had an_expense pense allowance or charged ‘expenses to your employer, check here (and see page 7 of Instructions. 060—-10—-78522-1 es a
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Reference copy, JFK Collection: HSCA (RG 233) JFE £SSASSINATION COLLECT TION IDENTIFICATION FORM \genceyv: ESCA 73) OO WA, vecord Wwumper: Yecord Series:  WOMBERED FILES heency File Number: OO “ETL originator: Cthten . (R Sia) ; Da nah From: . wR by, Namuel.......2 2 ee ee ee ee R Tor...-- ee oa Kk Title: ool ee ele ee ee ee ee eee K Date: | -@ U-7¥ Pages: 169 Subsectes: 0... URGE a heh ae R Sollee DRY een Be Khaw hee ne Avs ot see! cord Cole oa And ee ee ee ee ee ee eee R Bo cece e eee ene eeee R Goo ee ee cc ee ee ee ee ee eee R Locument Type - Othe. Tertyal ; aN . Classitication: o> C 5 T Restrictions: Open 16 1B ac 2(3) 4 Current Status: O Ce x U) iva) Date of Lest Review: / /393 (pening Criterin: . . t ~ Comments: uf Cave rm ae Box 4: 102 Koider Tatie: NW 55923 Docld:32245535 Page 171
Reference copy, JFK Collection: HSCA (RG 233) BES INDIVIDUAL INCOME TAX LACE PREADDRESSED LABEL HERE, If available. (Correct name and address, if necessary) Check Calendar Year ater social security number(s) only if incorrect or not shown on label. erence { One: C) Fiscal Year Ending _______-1977 NAME a joint return, give first names ‘and initials of “ both) PRESENT HOME ADDRESS (Number and street, including apartment number, or rg hol toute) eee | CRN ener cree ae nS aa OTN <1 ATTACH COPY 2 OF FORM W-2 HERE > Bite social security number on check or money order. ATTACH HERE > FILING STATUS CITY, TOWN OR POST OFFICE, STATE AND “ZIP CODE 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 34 4 © Head of Household—Enter name of qualifying 15 2 Widow(er) with dependent child (Year spouse died 197_)} “FOR "PRIVACY "NOTIFICATION SEE PAGE 2 OF INSTRUCTIONS Fi l l Es . ocial urit = A 2) eo 1 © bs p7 6 Personal if line 1 or 3 ‘checked, enter $25 If line 2, 4 or 5 checked, enter $50. 7 Dependents — Do not list the person who qualifies you as head of household oo eI Sr — Fee e Total Number <x $80] 7 {be 80 Blind (see instructions) Number of blind exemptions ___— x $8 00 Total exemption credits (add lines 6, 7 and 8) Enter here and on 1 tine 20 individual | CREDITS 8 a ( Attach copy 2 of Formis) W-2 to. ‘face of this 1 CF Wages, salaries, tips and other employee compensation) Foturn. if unavailable, see instructions, Page 10° rs. le eee Dividends—before federal exclusion. Enter total (if over $400, complete and attach Schedule B(540) ) Interest. Enter total (if over $400, complete and attach Schedule B(540)) income other than wages, dividends and interest (from line 48) Total {add lines 10, 11, 12 and 13) Adjustments to income (from line 55) . Adjusted gross income (subtract line 15 from line 14) © If you do NOT itemize deductions AND line 16 is under $15,000, find tax in Tax Table and enter on line 19. © If you itemize deductions OR line 16 is $15,000 or more, complete fines 17 and 18. Deductions: Itemized (from line 63) OR STANDARD ($1,000 if line 1 or 3 checked—$2,000 if tine 2, 4 or 5 checked) Taxable income (subtract line 17 from line 16) Compute tax from Tax Rate Schedule—Enter tax on line 19 Tax from (check one) [_] Tax Table ‘Tax Rate Schedule ([] income Averaging Schedule (G or Gel) . Total exemption credits (from fine 9, above) . Lo Tax liability (subtract line 20 from line 19—if line 20 is greater ‘than line 19, enter zero) Other credits (from line 68—including Special Low Income Tax Credit) . Net tax liability (subtract line 22 from line 21—if line 22 is greater than line 21, enter + zero) Other taxes (from line 71)... ee Total tax liability (add lines 23 and 24) Total Catifornia income tax withheld (attach W-2 or W-2P to face of this return) . . BY 26 | Renter’s credit—if you lived in rented property on March 1, 1976, complete Part 1 on page P ES 27 jo. 1976 California estimated tax payments . 2 2 2 2. eee ee Lo ¢ 28 eee Excess California SDI tax withheld (see instructions) . Total Credits. 20. 0 0 If tine 25 is larger than line 30, enter BALANCE DUE. If it is equal to line 30, enter zero Mail return to: FRANCHISE TAX BOARD. ————————————_ PAY IN FULL —> =P SACRAMENTO, CA 95867 Do not write in these spaces If line 25 is smaller than line 30, enter amount OVERPAID Amount of line 32 to be REFUNDED TO YOU. Allow at least six weeks. Mail return to: FRANCHISE TAX BOARD P.0. BOX 13-540 SACRAMENTO, CA 95813 Amount of line 32 to be credited on your 1977 ESTIMATED TAX. . .eal34] | if you do NOT want State income tax forms and instructions mailed to you next year, check here im See Instructions, Page 9 uA RIO Under penalties of perjury, | declare that | have examined this return, including accompanying schedules and statements, and to the:best of my knowledge and belief it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. SIGN yaaa | - | | 55923 Docld:32245535 Page 172 Date
“oe ~ Reference copy, JFK Collection: 4HSCA (RG 233) eS EER : Hee = Page-2-Form 540-1976) | cs ~ PART | ~ Renter’s Credit — All questions must be answered 35 Did you, on March 1, 1976, live in rented property which was your principal residence? ... 6 Yes ‘eptto If no, you may not claim this credit 36 Was the property you rented exempt from property tax? . . ee O Yes ONo _ If yes, you may not claim this credit 37 Did you tive with any other person who claimed you as a dependent for income tax purposes?... . OYes ONo If yes, you may not claim this credit 38 Did you or your spouse claim the homeowners’ property tax exemption or receive public assistance?. OYes ONo_ If yes, see page 3 of instructions a PART II — Other Income 39 Business income (or loss) (attach Schedule C(540)) 2. 40 Net gain (or loss) from sale cr exchange of capital assets (attach Schedule Di540)). 6. 6 ee 41 Net gain (or loss) from supplemental schedule of gains and losses (attach Schedule D-1{540)), 2. 2. we ee ee ee 42 Pensions and annuities 43 Rents and royalties .... scutbuce DULE E 44 Partnerships ... 2... FORM (540) 45 Estates and trusts 46 Farm income (or loss) (attach Schedule F(540)) 47 Miscellaneous income (a) Fully taxable pensions and annuities (not reported on Schedule E(540)) (b) Alimony ..... cc (c) Other (state nature and source) : _ Enter total of tines 47(a), 47(b), and 47(c) 2 6 2 we Total (add lines 39 thru 47). Enter here and on line 13. 2... ee ee PART Ill — Adjustments to Income 49 ‘Sick pay,’’ if included in line 10 (see instructions - attach Form FTB 3805T) ©. 6. 2 ee ee OPA LL ee eeceecedecceecs 50 Mbpving expenses (see instructions - attach Form FTB3805U) ©) 0/50 |. 51 Employee business expenses (See instructions - attach Form FTB 3805N). 2 2. OP Dee 52 Military exclusion (see instructions) - - - 0 ee 53(a) Payments to an individual retirement arrangement (attach FTB 3805P) 2.) J PBA (b) Payments to a Keogh (H.R. 10) retirement plan. 2.) FSS B fe (c) Payments to a self-employed ‘‘Defined Benefit Pian’’ Enter total of tines 53(a), 53(b), and 53(c) 54 Forfeited interest penalty (see instructions), |. 55 Total adjustments (add lines 49 thru 54). Enterhereandonlinels 2 2 | ee PART IV - Itemized Deductions e Attach Schedule A(540) and enter sub-totals on lines 56 thru 62, below 56 Total deductible medical and dental expenses (from Schedule A(540), line 10) 57 Total taxes (from Schedule A(540), tine 17). 6 6 ee 58 Total interest expense (from Schedule A(540), line 20) ---- ++: a 59 Total contributions (from Schedule A(540), line 24) 2. 6. ee 60 Total casualty joss (from Schedule A(540), line 29)... 6 ee 61 Tota! miscellaneous deductions (from Schedule A(540), line 33)... 2 62 Total child care and adoption expenses (from Schedule A(540), line 37). 2... ee 63 Total itemized deductions (add lines 56 thru 62). Enter here and on line17 2. PART V — Other Credits - SEE INSTRUCTIONS FOR EACH CREDIT CLAIMED BELOW 64 ‘Other State’ net income tax credit (attach copy of other state return and Schedule S(540)). © 6 6 2 ee ee 64 J 65 Retirement income credit (attach Schedule R(540)) 2 6. 66 Special low income tax credit (see special instructions) 67 Solar energy tax credit (see special instructions). ... 1... +... .e ee te 68 TOTAL (add lines 64 thru 67). Enter here and on line 22 PART VI — Other Taxes 69 Tax on preference income (see instructions - attach Schedule P(540). 2. 2... ee ee ee ee ee [69 fe pee 70 Tax on premature distributions from attached Form FTB 3805P 6 ww NW 55923 Dooid:32245535 Page i735
sa we ite aero eee eecttttemy ee Reference copy, JFK Collection: HSCA (RG 233) SCHEDULE FORM 840 __| Name as shown on Form 540 Medica! and dental expenses (not compensated by Insurance or otherwise) for medicine and drugs, doctors, dentists, nurses, hospital care, Insurance premiums for medical care, etc. 1. One half (but not more than $150) of Insurance premiums for medical care....................... 2. Medicine and drugs....................0..00000, 3. Enter 1% of line 16, Form 540.................00.. 4. Subtract line 3 from line 2. Enter difference (if less than zero, enter zero)... 6... eee 5. Enter balance of insurance premiums for medical care not entered on line 1......................02.0000% 6. Other medical and dental expenses: (a) Doctors, dentists, nurses, etc.................. (b) Hospitals .0....002.00..0.., “cece eee ces (co) Other (itemize) eee ee ees eeecenceeneeeeeecetneeee 9. Subtract line 8 from line 7. Enter difference (if less than zero, enter zero).......................085 10. Total—tAdd lines 1 and 9. Enter here and on Form 540, line 56)... 00. eee 144 | Taxes 11. Auto license—Excess of registration and weight fees (see instructions).............00.00..00 000 cece ee 12, Real estate... 000.2. 13, State and Jocal gasoline...................0-.00.. 14. General Sales........00.0... 0... cee eee 15. Personal property (Boat and Aircraft).............. 18. Other (itemize) eee eee ec ee ecer ee eenneeeeee 17. Total taxes—(Add fines 11 thru 16. Enter here and on Form 540, line 57) .............. 000 eee eee ee Mes Interest Expense 18. Home mortgage 19, Other (itemize).........0.... en Se 20. Total—(Add fines 18 and 19. Enter here and on Ci Form 540, tine 58)..0.00 00... cee eee eee eee J NW 35923 Doold:32245535 Page if4 CALIFORNIA "ITEMIZED DEDUCTIONS Attach to Form 540 USE ONLY IF YOU DO NOT USE THE TAX TABLE OR TAKE THE STANDARD DEDUCTION . Contributions 21(a). Cash contributions for which you have receipts, canceled checks, etc. (b). Other cash contributions. List donees and amounts ment 23. Carryover from 1974 & subsequent years — See instructions 24. Total— (Add lines 21a thru 23. Maximum de- duction may not exceed 20% of adjusted gross income. Enter here and on Form 540, line 59)..... Casualty or Theft Loss(es) NOTE: If you had more than one loss, omit tines 25 through 28—See instructions for guidance 25. Loss before insurance reimbursement ........----> 26. Insurance reimbursement..................00.0.00. 27. Subtract line 26 from line 25, Enter difference (lf less than zero, enter zero) ©... 2 eee - 28, Enter $100 or amount on line 27, whichever is smaller. . 29. Casualty 0 or theft loss 5 (subtract tine 28 from line 27, Enter here and on Form 540, line 60) Miscellaneous Deductions © 30. Alimony paid to: oc... ccc eee cece reece ene ee ee nes 31, Employment Education Expense. 32. Union dues Other (itEMiZE) 2... eee ee cee etc ee cc ceseneeeceteccteteceeree  [tcceeceeccceeceecerserefenseeee 33. Total (Add lines 30 through 32. Enter here and on Form 540, fine 61) Child Care and Adoption Expense 34. Child care expenses — Attach Form 3805X..... sevens 35. Total adoption expense. ... - | Less 3% of line 16, Form 540. - 36. Net adoption expenses —See instructions for maximum limitations. 2... 2 eee ee ee 37. Total child care and adoption expenses (add tines 34 and 36. Enter here and on Form 540, tine 62)... ..-.......2..006 Lal a coer: LEM is jodie
Reference copy, JFK Collection: HSCA (RG 233) “""r"sskieETr DIVIDEND AND INTEREST INCOME Attach to Form 540 7 ihe. ‘FORM 840 lame as shown on Form 540 PART I---DIVIDEND INCOME Line 1—Gross Dividends and Other Distributions on tock——lf gross dividends and other distributions (including capital ain dividends) on stock were $460 or less, do not complete tions), less nontaxable portion, if any, on Form 540, page 1. Do NOT deduct the $100 federal exclusion. “Capital gain dividends” are treated as ordinary dividends for State income tax purposes and not as capital gains as permitted ; ? is part; but enter gross dividends (including capital gain distribu- under the federal law. Gross dividends and other distributions on stock—List payers and amounts—Write (H), (W), (J), for stock held by husband, wife, jointly. Total dividends 2 2. fe pee tce teen eee ee Nontaxable distributions . Se kk kk ee ke . Taxable dividends—Subtract fine 3 from line 2. Enter here and on line 11, form 540 PART It—INTEREST INCOME Interest on bonds, debentures, loans, notes, tax refunds and all pes of savings accounts including banks, credit unions and postal avings is taxable. Interest on the following obligations is exempt from tax: (a) Bonds and other obligations (other than tax refunds) of the United States, the District of Columbia and territories of the United States. (Interest on Philippine Islands obligations issued on or after March 24, 1934 is not exempt.) (b) Bonds (but not other obligations) of California and its polit- ical subdivisions issued after November 4, 1902. (c) Interest on bonds of Alaska and Hawaii issued prior to their achieving statehood. Note: If total taxable interest income was $400 or less, do not complete this part; but enter the total amount of interest received on Form 540, page 1. WW 55923 Docld:32245535 Page i75
paws HSCA (RG 233) “SSS PROFIT (OR LOSS) FROM BUSINESS OR PROFESSION (Sole Proprietorships) tach this echedule to your Incomo tax return, Porm 340 or 540NR — Partnerships, Joint ventures, ote., must file on Form 565 | Security Nu me as shown on Form 540 or 540NR Ly ae EA a . B. Federal Employer 1.D. No. 26 NOUR, GS ~ Ze gs Name and Address of Business boplty PisTRo Cofr?: OHp7 it eitaep Pup Principat business activity (i.e., retail-hardware; wholesale-tobacco; services-legal; ete) SARVIEE > So eeeneeeeees 21! oe) _{ndicate method of accounting: C cash; Sseracerual, CO) OCR Teac eee cece eter eerrececensentnnmenestneceranertammmnrrsaenes cov eeeeeeee eesenesueeneeneenss Were Forms 591, 592, 596 and 599, Cee year filed (if required)? YES — NO Method of inventory valuation B_...... Yenc tee nent a en A sh Was there any substantial change in the manner of determining quantities, costs, or valuations between the opening and closing inventories? Cc YES ©) NO If.“Yes,” attach explanation. 222 1 Gross receipts, sales, or fees $.........---—-—----- Less returns and allowances $........--.-----------------e Balance & - 2 Inventory at beginning of year (if different from last year’s closing inventory, attach explanation)........... 3 Purchases $............—--.-—-.---—-Less cost of items withdrawn for personal use $.............. eevesetnecnetetncnsrenencnce | 4 Cost of labor (do not include salary paid to yourself). 0.2... cece eect eet eee ees 5 Materials and supplies............. 0.6... eee ee creer ees vce cee evn etrreeeeenes T —SC 6 Other costs (explain in Schedule C-2 or attach Schedule)... 00. cecsseee eta SY 7 Total of fines 2 th 6 oo cecce ccc cece certs teeter cesses [ C—C—C—szY 8 Inventory at end of this year... 0.0.66 eens eee C—O 9 Cost of goods sold (subtract line 8 from line 7)......-.0-- -- 0s eee ES Gross profit (subtract line 9 from line 1 1 Other income (attach schedule). ..........0 000.0 cee seen teeeeresen ees ene ne ees eee 2 Total Income (add fines 10 and 11)..0. 0.2.0 eee ets genes es eee . OTHER BUSINESS DEDUCTIONS '3 Depreciation (explain in Schedule C-1 or attach Schedule)..........0..0..0 2065 ee ee ce cette fC :4 Taxes on business and business property (explain in Schedule C-2 or attach Schedule)................0005- _ i5 Rent on business MODMY. osc esccscescseseeceesesetsetessvcereenteeetseeereces rn CST °@ Repairs (explain in Schedule C-2 or attach Schedule)..........0. 00 cece eee eee re CSS ' ’ 17 Salaries and wages not included on line 4 (exclude any paid to yourself)............ .6 22ers i8 Insurance ..... been beer etre rete pete Enter e eer n tresses rere renee es 19 Legal and professional fees......... ee Cd 20 Commissions ............ 0 cee e cece ene n eres r sence Lecce ee 14 Amortization (attach statement) . | Cid 72 Retirement plans, etc. (other than your share, see instructions)... 0.0.0.0 oo ce ee rr 3 Interest on business indebtedness................-.02 00sec eee ccc eee ee eet eee "24 Bad debts arising from sales or services (Not applicable if reporting on caf, basis)... eee eee T—SY 5 Depletion (attach schedule)..........00cccccce teeters eae SY 96 Other business expenses (explain in Schedule C-2 or attach Schedule)............. 0... .0 00. c eee eee Td « 27 Total of lines 13 thy 26.00.0062 ect re rset a Bilbao 28 Net profit (or loss) (subtract line 27 from line 12), Enter here and on Page 2, Form 540 or S40NR....... ey x. | Deen’ me <—¢ . Group and guideline class Date Cost or Depreciation Method of Life or Depreciation 3 wage F . allowed (or allowable) computing pres -en or description of property Acquired other basis in prior years depreciation Rate for this year ose PS a aes En eo as aac es ee ee ee AC S ns NS a < Oe LINE EXPLANATION (| AMOUNT LIne EXPLANATION AMOUNT nation of Lines 4, 16, and 26. Schedule €-2 Expla' , 6,1 2 a $ ch
° oo : 2 ee aE a) Reference copy, JFK Collection: HSCA (RG 233) ! a CAPITAL GAINS AND LOSSES Attach to Form 540 or 540NR et SCHEDIWS Igy Use this schedule to report gains and losses on stocks, bonds and similar investments, and gains (but not losses) on personal assets such as a home or jewelry. Name as shown on Form 540 or 540NR ; ; ; fy PART Il—Assets Held One Year or Less a. Kind of property and description | 6. Date acquired (Example, 100 shares of ‘2 Co.) (mo., day, yr.) @. Cost or other basis as adjusted, cost of subse- d. Gross sales quent improvements (if f. Galn or loss price not purthased, attach (d. fess 8.) explanation) c. Date sold {mo., day, yr.) pense of sale 2. Enter gain ‘(or loss), if applicable, from line 17, Schedule D-1 (540) (attach copy) . 3. Enter. your share of net gain or loss from partnerships. and fiduciaries . 4. Net gain or loss, combine lines 1, 2 and 3 PART il—Assets Held More Than One Year But Not Moro Than Five Years eeeseneeeseeseceneeneeeseneetetsettenes oS 3S nA 17h ee oe ee 6, Enter gain (or loss), if applicable, from line 19, Schedule D-1 (540) (attach copy) . 7. Enter your share of net gain or loss from partnerships and fiduciaries . Loe ee 8. Net gain or loss, combine lines 5, 6-and 7 (If gain, see 540 instructions, line 24a (Preference Income)) PART Hi—Assets Keld More Than Five Years 10. Enter gain (or loss), if applicable, from line 21, Schedule D-1 (540) (attach copy) . 11. Enter your share of net gain or loss from partnerships and fiduciaries . os toe ee 12. Net gain or loss, combine lines 9, 10 and 11 (if gain, see 540 instructions, tine 24a (Preference Income)) 2ART IV——Summary of Capital Gains and Losses 13. Enter amount from line 4 14, Enter 65% of the amount on line 8 . . 15. Enter 50% of the amount on line 12. . . 16. Enter unused capital toss carryover from preceding taxable eld 25.,%, computation 17. Combine the amounts shown on lines 13, 14, 15 and 16 18. If line 17 shows a gain, enter here and on page 2, Part il of Form 540. or '540NR . 19. If line, 17 shows a loss, enter here and on page 2, Part Il of Form 540 or 540NR the smallest oft (a) amount on lines 17; (b) the taxable income for the taxable year (computed without regard to gains or losses from sale or exchange of capital assets; or aon (c) $1,000 ($500 in the case of a husband or wife filing a separate return) 2. . 2... wl, OO WwW 55923 Doold: 32245535 Page —_
RESIDENT “ INDIVIDUAL ; D fv CALIFORNIA INCOME TAX PLACE PREADDRESSED LABEL WERE, if available. (Correct name and address, if necessary) | theck  Suctalendar Year Enter social security number(s) only if incorrect or not shown on label, FILING STATUS ovece tay One: 1 © Single 2 30 Separate return of martied person—Enter spouse's social security number and full name here 4 () Head of Household -—Enter name of qualifying individual. wae on ATTACH FORM DE 1964 HERE Write social security number on check or money order. ATTACH HERE » NW 5592 “<< ATTACH COPY 2 OF FORM W-2 HERE > Married filing joint return (even if only one had income) C) Widow(er) with dependent child (Year spouse died 197___}1 9 Total exemption credits (add lines 6, 7 and 8) Enter here and on line 20 10 11 12 13 14 15 16 7 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 NAM PRESENT HOME ADDRESS (Number and“fttraet tt apartment numbe Sb 2S o__ by RK Reference copy, JFK Collection: HSCA (RG 233) One: (7) Fiscal Year Ending a 1976 FOR FEDERAL PRIVACY ACT NOTIFI- CATION SEE PAGE 2 OF INSTRUCTIONS LAST NAME UB Y | ural route) If joint return, give first 2; initials of ra CA MUEL L Pa AYLL JEK Act 6 (3) R POST spf STATE AND ZIP COD Occu- PATION Spouse's EXEMPTION CREDITS. { If line 1 or 3 checked, enter $25 6 Personal { lf line 2, 4 of 5 checked, enter $50 re : 7 Dependents — Do not list yourself, your spouse o: the person who qualifies you as head of household. Enter name and relationship. ELISA Ce _.TCH. bh. So. ene “Total Number @ . en 8 Blind (refer to instructions) Number of blind exemplions ® aw XK $8 inn! Attach copy 2 of Form(s) W-2 to face of this ) Wages, salaries, tips and other employee compensation) joturn. if unavailable, see instructions, Page & 4 Dividends—before federal exclusion. Enter total (if over $400, complete and attach Schedule B(540)) Interest. Enter total (if over $400, complete and attach Schedule B(540)) Income other than _e dividends and interest (from line 48) Total (add fines 10, 11, 12 and 13) Adjustments to income (trom tine 55) . Adjusted gross income (subtract line 15 from line 14) rn Ce © If line 1 or 3 is checked and line 16 is $4,000 or less, enter zero tax on line 23, Do not complete © If line 2, 4, or 5 is checked and line 16 is $8,000 of less, enter zero tax on line 23. 7 fines 17 thru 22 @ If you do NOT itemize deductions AND line 16 is under $15,000, find tax in Tax Table and enter on line 19. © If you itemize deductions OR tine 16 is $15,000 or more, complete lines 17 and 18. Deductions: Itemized (from line 62} OR STANDARD ($1,000 if line 1 or 3 checked—$2,000 if fine 2, 4 a 5 checked) Taxable income (subtract tine 17 trom fine 16) Compute tax fyom Tax Rate Schedule—Enter tax on line 19 Tax from (check one) Tax Table ( Tax Rate Schedttagq . Income Averaging Schedule (G or G-1) O Total exemption credits (from line 9, above) Tax liability (subtract tine 20 from line 19—if line 20 is greater ‘than line 19, enter zero) Other credits (from line 65) Be, Net tax liability (subtract line 22 from line 2!—if line 22 is greater than tine 21, enter zero) Tax on preference income (see instructions—attach Schedule P(540) ) Total tax tiability (add lines 23 and 24) Total California income tax withheld (attach W-2 or W-2P to face of this return) Renter's credit—if you lived in rented property on March 1, 1975, complete Part 1 on page 2 1975 California estimated tax payments Excess California SDI tax withheld {attach Form DE 1964 t to face of this return) . Total prepayment credits (add lines 26 thru 29) If line 25 is targer than line 30, enter BALANCE DUE. ff it is equal to line 30, enter zero. . Pay in full and mail with return to: FRANCHISE TAX BOARD PAY IN FULL ——> B& — 8 SACRAMENTO, CA 95867 IN FUL 0 Do not write in these spaces If line 25 is smaller than line 30, enter amount OVERPAID Soe ee ee Amount of line 32 to be REFUNDED TO YOU. Allow at least six weeks, Mail return to: FRANCHISE TAX BOARD a 33 P.0. BOX 13-540 SACRAMENTO, CA 95813 Amount of line 32 to be credited on your 1976 ESTIMAILD TAX. aj] Td <——— ESTIMATED TAX ; Under penalties of perjury, | declare that | have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it is true, correct and complete. If prepared by a person other than taxpayer, his declaration is based on all information of which he has any knowled3e. SIGN >... signature Date > 3 Docl@"s2 299535! ‘WiBage TTS Mate PRT ae Preparer’s signature (other than taxpayer)
Reference copy, JFK Collection: HSCA (RG 233) ae > . eee Ne - TD Re rr) ee ae, _ _ ae - > i CALIFORNIA ITEMIZED DEDUCTIONS Attach to Form 540 on Form 540 If your adjusted gross Income is $8,000 or less and your filing status is ‘Married, Filing Join cr $4,000 or fess and your fillng status Is “Single,” or “Married, Filing Separately,” do not itemize, enter zero on Form 540, line 23, and check the tax A table box. Name as show USE ONLY IF YOU DO NOT USE THE TAX TABLE OR TAKE THE STANDARD DEDUCTION Medical and dental expenses (not compensated by insurance or otherwise) for medicine and drugs, doctors, dentists, nurses, hospital care, insurance premiums for medical care, etc. Interest Expense 21. Home mortgage 0 petceeenesceteeceteetemedf eesees 22. Other (itemize). peteeeeceeetenceeeeeteeteef ceseenes 1. One half (but not more than $150) of insurance premiums for medical care : 2. Medicine and drugs . . wee 3. Enter 1% of line 16, Form 540 23. Total-—(Add lines 2! and 22. Enter here and on 4. Subtract line 3 from line 2. Enter difference (if less Form 540, line 59) Bee than zero, enter zero) ; . nee 5. Enter balance of insurance premiums for medical care not entered on line 1.. 2... 6. Other medical and dental expenses: (a) Doctors, dentists, nurses, etc. ........ 0. 0... Contributions — 24. Cash contributions for which you have receipts, canceled checks, ete. 20 0.0.0.0 00. eee 25, Other cash contributions. List donees and amounts (b) Hospitals 90000 ee ee (c) Other (itemize)... eee eeceeeeeeeee ener 26. Other than cash.—See instructions for required state- Ment eee 27. Carryover from 1974—See instructions.......... 28. Total—tAdd lines 24, 25, 26, and 27. Maximum de- duction may not exceed 20% of adjusted gross income. Enter here and on Form 540, line 60)...... 7. Total—(Add tines 4, 5, 6a, b, and c)...... ....... 8. Enter 3% of line 16, Form 540.......... ........ 9. Subtract line 8 from line 7. Enter difference (if less than zero, enter zero)........... ee, 10. Total—Add lines 1 and 9. Enter here and, on Form 540, line 56)..... 0....... CL A 7 Miscellaneous Deductions Child Adoption Expense Casualty or Theft Loss(es)—See instructions 11. Total expenses paid or incurred—Attach itemized list 12. Enter 3% of line 16, Form 540.................. NOTE: If you had more than one loss, omit lines 29 through 33 and follow instructions for guidance. 13. Subtract line 12 from line 11—See instructions for 29. Loss before insurance reimbursement.............. maximum limitations. (Enter here and on Form 540, 30. Insurance reimbursement line ST). cee 31 . Subtract line 30 from line 29. Enter difference (if line 30 is greater than line 29, enter zero) 32. Enter $100 or amount on line 31, whichever is smaller 33. Casualty or theft loss (line 31 Jess fine 32)........ 34, Alimony paid... eee 35. Child care—See instructions...................... 36. Union dues........ cee 37. Employment education expense—See instructions.... 38. Other—titemize) Taxes 14. Real estate... eee 15. State and local gasoline.........0...00. 0.0 eee 16. General Sales... 00... oo c ee c cence 17. Auto license—Excess of registration and weight fees (see instructions)............... 00.0 c eee eee ee 18. Personal property (Boat and Aircraft)....... Svea 19. Other (itemize) 39. Total—Add lines 33, 34, 35, 36, 37, and 38. (Enter here and on Form 540, line 61)
: Reference copy, JFK Collection: SCA (RG 233) t Lee _ . . ar ; ae ete ee _- i TAXABLE PROFIT (OR LOSS) FROM BUSINESS OR PROFESSION (Sele Proprioterships) brit FORM 340 Attach this schedule to your Incomo tax un, Porm 540 or S4ONR —_—— Partvorships, joint vontures, ofc., must Alo oa Form 565 Name as shown map 540 or S40NR A. Name and Address of Businesyy ; y f ; B. Federal Employer |.D. No. Wooprey Litt ho loFFs Hor 9S5-DbSISF IL C. Principal business activity (i.e, retailhardware; wholesale-tobacco; services—legal; te) —~ERVYICE =) lL ‘Sf _.. D. Indicate method of accounting: O cash; pores Ot Occ cca ceeneenneseenesenenenscesteceenecenneesnesceaeenenssssanecsaesemescemeecessonensasetorseenaeanaess E. Were Forms 591, 592, 596 and 599, for the ce - filed (if required)? ihves G NO F. Method of inventory valuation > __......... 7a 6 SE eescensesueeeeeseceveeveenssssssnevetessnseeaseesin ssnsecucasnasenseessessucssaneessssesnsecansece sect snaesenneeste Was there any substantial change in the manner of determining quantities, costs, or valuations between the opening and closing Inventories? oO YES [1 NO If “Yes,” attach explanation. ; > 1 Gross receipts, sales, or fees $0.0 .................Less returns and allowances $ o.oo eee ; Balance > 2 Inventory at beginning of year (if different from last year's closing inventory, attach explanation) 3 Purchases $. Less cost of items withdrawn for personal use $ ..... 4 Cost of labor (do not include salary paid to yourself) , 5 Materials and supplies................. 0 ..... ; 6 Other costs (explain in Schedule C-2 or attach Schedule). ...0 2 2... 20. Lee. 7. Total of lines 2thu6........... rere 8 inventory at end of this year............... eens 9 Cost of goods sold (subtract line 8 from line 7) 10 Gross profit (subtract line 9 from line 1) 11 Other income (attach schedule).......0 0.00 2.0.00, 12 Total Income (add lines 10 and 11)..... .... too. OTHER BUSINESS DEDUCTIONS 13 Depreciation (explain in Schedule C-1 or attach Schedule) . . 14 Taxes on business and business property (explain in Schedule C-2 or attach Schedule). .. 15 Rent on business property ... ....... . 16 Repairs (explain in Schedule C-2 o1 attach Schedule) 17 Salaries and wages not included on tine 4 (exclude any paid to yourself) WW Insurance cree beeen treed 19 Legal and professional fees. 0 000. cece cence tee 20 Commissions ... ...... ... .... 21 Amortization (attach statement) .. . Fe lee 22 Retirement plans, etc. (other than your share, see instructions) .. ... 23 Interest on business indebtedness.......2.....00 22. eee. 24 Bad debts arising from sales or services (Not applicable if reporting on cash basis). ... 25 Depletion (attach schedule)... eee beeen eens 26 Other business expenses (expiain in Schedule C-2 ar attach Schedule).......0 0..0.00000... . 27~—s Total of Wines 13 thru 26.0000 ccc cece of MN, 28 Net profit (or toss) (subtract line 27 from line 12), Enter here and on Page 2, Form 540 or S40NR ao C mo , AG GY Group and guideline class Date Cost or Depreciation Method of Life or Depreciation ae : : allowed (or allowable) computing ; or description of property Acquired other basis in prior years depreciation Rate for this year Schedule C-1 Depreciation Claimed on tine 13. ws Ss fe eek eo ae es ee ee ee 5 i ee Bw aso (ocid: 3224a5535 Page Iso
Reference copy, JFK Collection: SCA (RG 233) @ CALIFORNIA CAPITAL GAINS AND LOSSES Attach to Form 540 or 540NR SCHEDULE |’ FORM 540 Use this schedule to report gains and losses on stocks, bonds and similar investments, and gains (but not losses) on personal assets such as a home or jewelry. PART i—Assets Hold One Year or Less @. Cost or other basis as adjusted, cost of subse- quent improvements (if Rot purchased, attach explanation) and = ex- pense of sale 1. a Los 5 Care (Ta: nn eee eee oe nn — a (r0;3 60: ope poe a a Ase peta (OD! « fe an eS a. Kind of property and description (Example, 100 shares of ''Z" Co.) b. Date acquired {mo., day, yr.) ¢. Date sold (mo., day, yr.) d. Gross sates price f. Gain or loss (d. fesse.) 2. Enter gain (or loss), if applicable, from line 18, Schedule D-1 (540) (attach copy) . 3. Enter your share of net gain or loss from partnerships and fiduciaries . 4. Net gain or loss, combine lines 1, 2 and 3 _ PART ll—~Assots Held More Than One Year But Not More Than Five Years 6. Enter gain (or loss), if ‘applicable, from line 20, Schedule D-1 (540) (attach copy) Coe IOS. oe 7. Enter your share of net gain or loss from partnerships and fiduciaries . So 8. Net gain or loss, combine lines 55,6 0nd7 2 2 1 we 70 ‘ PART Ill—Assots Held More Than Five Years 10. Enter gain (or loss), if applicable, from line 22, Schedule D-1 (540) (attach copy) . 11. Enter your share of net gain or toss from partnerships and fiduciaries . 12. Net gain or loss, combine lines 9, 10 and 11 PART iV—Summary of Capital Gains and Losses 13. Enter amount from line 4 . 14. Enter 65% of the amount on line 8 15. Enter 50% of the amount on line 12 . . 16. Enter unused capital loss carryover from preceding taxable years (attach compotion 17, Combine the amounts shown on lines 13, 14, 15 and 16 . 18. If line 17 shows a gain, enter here and on page 2, Part Il of Form 540. or ‘540NR 19. If line 17 shows a loss, enter here and on page 2, Part II of Form 540 or 540NR the smallest of: (a) amount on lines 17; (b) the taxable income for the taxable year (computed without regard to gains or losses from sale or exchange of capital assets; or Mw 5596) SIDAMIGSRO fa aoe Bdge hadihnd or wife filing 9 canarate return)
Reference copy, JFK Collection: HSCA (RG 233) eek oe de ca atest at aici 1 i ee L. Me IO INDIVIDUAL CALIFORNIA INCOME TAX PLACE PREADDRESSED LABEL HERE, if available. (Correct name and address, if necessary) For calendar year or Enter social security” number(s) only if incorrect or not shown on fabel. , [Taxable year ending —_—. __, 197 as PN ve Te SE See STE ne WaT Tanya CE PPR oe aes Seren eee Peers TS Your Social Security Number ‘ NAME ( int return, give first ,and initials of both) _AMUELA H + a 1g ' Security art hah te oe cera sear EXEMPTION CREDITS fu If line 1 or 3 checked, enter $25 6 Personal If line 2, 4 or 5 checked, enter $50 } . 7 Dependents — Do not list yourself, your spouse or the person who qualifies you as of household. Enter name and relationship. _ a) a a 4 () Head of Household—Enter name of qualifying Total Number > _a x $8 individual ~ -}8 Blind (refer to instructions) Number of blind exemptions > __. FILING, STATUS—Check ‘Only ‘One: 1 2 Single 2 Married filing joint return (even if only one had income) 3 DD Separate return of married person—Enter spouse’s social security number and full name here 10 Wages, salaries, tips and other employee compensation {| Attach copy 2 of boem(s) w2 ta face of this | V return. tf unavailable, attach explanation. 11 Dividends—before federal exclusion. Enter total (if over $400, complete and attach Schedule B(540)) 12 Interest. Enter total (if over $400, complete and attach Schedule B(540)) 13 Income other than wages, dividends and interest (from line 48) 14 Total (add lines 10, 11, 12 and 13) 15 Adjustments to income (from line 54) 16 Adjusted gross income (subtract line 15 from tine 14) + If you do NOT itemize deductions AND line 16 is under $10,000, find tax in Tax Table and enter on tine 19. ° If you itemize deductions OR line 16 is $10,000 or more, complete lines 17 and 18. 17. Deductions: itemized (from line 61) OR Standard ($1,000 if line 1 or 3 checked—$2,000 if fine 2, 4 of 5 checked? 18 Taxable income (subtract line 17 from line 16) Compute tax from Tax Rate Schedule—Enter tax on fine 19 19 Tax from (check one) Tax Table (7) Tax Rate Schedule ‘é Income Averaging Schedule (G o: G-1) 0 20 Total exemption credits (from line 9, above) . 21° Tax tlability (subtract line 20 from line 19—if line 20 is greater than line 19, ‘enter zero) 22 Other credits (from line 65—Includes special low income tax credit) . 23 Net tax Siability (subtract line 22 from line 21—if line 22 is greater than line 21, enter zero) 24 Tax on preference income (see instructions—attach Schedule P(540)) <@ ATTACH COPY 2 OF FORM W-2 HERE > ce a an tt ee nee “er en ee enon: 4 25 Total tax liability (add lines 23 and 24) « = 26 Total California income tax withheld (attach Form(s) W-2 or W-2P to face of this return) © 27 Renter's credit—if you tived in rented property on March 1, 1974, complete Part 1 on page 2 . E 28 1874 California estimated tax payments 3 29 Excess California SDI tax withheld (attach Form DE 1964 t to face of this return), E 30 Total prepayment credits (add lines 26 thru 29). . 2 Poa] _ = 31 If fine 25 is larger than line 30, enter BALANCE DUE. If it is equal to line 30, enter zero. —_ z E Pay in full and mail with retura to: FRANCHISE TAX BOARD PAY IN FULL —> a x SACRAMENTO, CA 95867 Do not write in these spaces  @ 32 If line 25. is smaller than line 30, enter amount OVERPAID zo Mail return to: FRANCHISE TAX BOARD “xs P.0. BOX 13-540 on 3s ; ; SACRAMENTO, CA 95813 3 3 33 Amount of line 32 to be REFUNDED. (Allow at least six weeks) --——— REFUND TO YOU -—» E £ 34 Amount of line 32 to be credited on your 1975 ESTIMATED TAX. . . 134) (sd Ea eatee RRR I A . J 2 Under penalties of perjury, | declare that | have examined this return, including accompanying schedules and statements, and to the best of my knowledge ond S. belief it is true, correct and complete. If prepared by a person other than taxpayer, his doclaration is based on all information of which he has any knowledge. 3 aad £ SIGN Bion signature Date B ica signature (other than taxpayer) Date ; as717 VANOWEN STREE b . Hw am, HER > ssancgaasse him Profactwies Dats Address (and Zip wid a a ae ae sone Preoarer’'s FEIN (or SSA) Wo. ae ROR ge reenter TP ET ee St ae ot el eaten a en Tee
Reference copy, JFK Collection: HSCA (RG 233) Leite CALIFORNIA ITEMIZED DEDUCTIONS Attach to Form 540 Use only it you do not use the Tax Table or take the standard deduction. Medical and dental expenses (not compensated by insurance or otherwise) for medicine and drugs, doctors, dentists, nurses, hospi- tal care, insurance premiums for medical care, etc. 1. One half (but not more than $150) of insurance premiums for medical care | 2. Medicine and drugs 2. 2 1. 1 1 ee hee eee dfiee ee interest Expense 22. Home mortgage . . 23. Installment purchases 24. Other (itemize) . 3. Enter 1% of adjusted gross income shown on Form 4. Subtract line 3 from tine 2. Enter difference (if line 3 is greater than tine 2, enter zero) . 4 5. Enter. balance of insurance premiums for medical care not entered on line 1 Le Loe 25. TotaktAd ines 22, 22, 23 ‘and 24, Enter here and * | 99) 6. Other medical and dental expenses: on Form page 2, line 58) . Lf pA (a) Doctors, dentists, nurses, etc. Contributions oo b) Hospitals . (b) Hosp) pans 26. Cash contributions for which you have receipts, ¢ can- {c) Other (itemize) . celed checks, etc. 27. Other cash contributions. List donees and amounts 7. Total—tAdd fines 4 5, ‘ba, b, and o) o. KS y.. 8. Enter 3% of adjusted _ Bross income shown on Cc ; Form 540 rn 28. Other ‘than ‘cash, _—s instructions for required 9. Subtract fine 8 from ine 7. Enter difference (if a statement Co line 8 is greater than line 7, enter zero) 28. TotalAdd lines 26, 27 and 28. Maximum deduction 10. Total—Add lines 1 and 9. Enter here and on may not exceed 20% of adjusted gross income. Form 540, page 2, line 55). . | > L133 Enter here and on Form 540, page 2, line 59) . > Child Adoption Expense Miscellaneous Deductions Casualty or Theft Loss(es}—See Instructions 11. Total 2xpenses paid or incurred—Attach itemized NOTE: If you had more than one toss, omit lines 30 list. a eee Cone through 34 and follow instructions for guidance. 12. Enter 3% of adjusted gross income shown on Form 30. Loss before insurance reimbursement M40... . Ft 31. Insurance reimbursement 13. Subtract line 12 from line 11—See instructions 32. Subtract line 31 from tine 30. Enter difference iit for maximum timitations. (Enter here and on Form dine 31 is greater than line 30, enter zero) 540, page 2, line 56). | v0 39. Enter $100 or amount on line 32, whichever is - smaller . Taxes 34. Casualty or theft toss ‘ine 32 less line 33) 14. Real estate 35. Alimony pald 15. State and local gasoline 36. Child care—See instructions 16. General sales 37. Union dues 17. Auto license—Excess of registration and weight f fees 38. Employment education expense —See instructions (see instructions) oe 39. Other—See instructions (itemize) . 18. Personal property . 19. State disability insurance (SDI)-—Employer private disability plans do not quatify . 20. Other . SCH i aeeeec tee seca ccen cen ceceerecteeennecnsens teaneanacananesseresneeeeneneenaeneute 21. Total taxes—{Add lines 14 through 20. Enter here. 40. Total—Add lines 34, 35, 36, 37, 38 and 39. (Enter NY paé@eg Docid: 32245535 and on Form 540, page 2, line 57) . Page 186 here and on Form 540, page 2, line 60) . . > ie alereetee eaten Kee ane sas
ws wR me - : — oo “~- Reference copy, JFK Collection: HSCA (RG 233) SCHEDULE PROFIT (OR LOSS) FROM BUSINESS OR PROFESSION (Sole Propristorships) FORM 340 Attach this schedule to your income tax return, Form $40 or S40NR —_—— Partnorships, joint ventures, otc., must filo on Form 565 Name as shown on Form 540. or S40NR ae, SOCISI Security Number A. Principal business activity aa: Rvrc E _ ..3 product... LA q “tha (See Instructions for “Item A.’ (For exomple; retail—-hardworez provers services—legal; manvfacturing—furniture; etc.) B. Business name.. We fa) OLE Y Biste (a) Cor FEES! ree thie ger tay) atecgen number. E52 ES. 2... D. Business address (40.65 V- NTUR A iy _C&a IGABIG.. E. Indicate method of accounting: —[_} cash; WE ocerval; 1 =e . ceceeneeeeeeeeeeee fF. Were Forms 591, 592, 596 and 599, a calendar year filed (if required)? a6 Yes” Dp ‘No G. Method of inventory valuation > “oT beets Was there any substantial change in the manner of determining quantities, costs, or - valuations between the ¢ opening 3 and closing Inventories? () YES NO. _ If “Yes,” attach explanation. IMPORTANT—AI! applicable lines and schedules must he filled in. Gross receipts or sales $. ——---_ Less returns and allowances $......-._____.. Balance Less: Cost of goods sold (Schedule C-1, line 29) and/or operations (attach schedule) . Gross profit . soe . Other income (attach schedule) TOTAL income (add lines 3 and 4) Depreciation (explain in Schedule C-3) Taxes on business and business property (explain in Schedule c. 2) Rent on business property Repairs (explain in Schedule C-2) . . 10 Salaries and wages not included on line 24, Schedule C- 1 (exclude a any ‘paid t to yourself) 11 Insurance . 12 Legal and professional fees . 13 Commissions . 14 Amortization (attach statement) 18 (a) Pension and profit-sharing plans (see Instructions for line 15(a)) : (b) Employee benefit programs (see Instructions for line 15(b)) 16 Interest on business indebtedness . 17 Bad debts arising from sales or services Se ek 18 Depletion . . Ce ee ee ee 19 Other business expenses es (specify):  ( ) a ieee Sine INCOME SDON ATU a ON = DEDUCTIONS (h). Total other business expenses (add lines 19(a) through 19(g)) . 2. 6 ww we eee ge 20 Total deductions (add lines 6 through 19). 6 6 we ee ee LM, 1s 21 Net profit (or loss) (subtract line 20 from line 5). Enter here and on page 2, Form 540 or Form 540NR © SCHEDULE C-1. COST OF GOODS SOLD (See Schedule C Instructions for line 2) 22 Inventory at beginning of year (if different from last year’s closing inventory, attach explanation) 23 Purchases $.. Loe Less cost of items withdrawn for personal use $.......................... Balance > 24 Cost.of labor (do n not include salary paid to yourself) . 25 Materials and supplies 26 Other costs (attach schedule) ce ke ee ek ee eee ke te 27 Total of lines 22 through 26 © 6 2 1 Lec cceceee tree ef ereetes 28 Less: Inventory at end of year . - 29 Cost of goods sold. Enter here and on line 2, ‘above Bev-S393@3 0 Doecld:32945535 Page 187 . “(ze code) ~ AN SEES 1 me OED Rema Vegrerreey srr eee eee eS a rnerpceieee are Ne ge gE Se merge ceremet yn tenn nine tt cae See a aesenciniaamerinreaneiiikent tanec nateaenesathraailiamteatebeiar eames
Reference copy, JFK Collection: HSCA (RG 233) va CALIFORNIA "FORM 540 CAPITAL GAINS AND LOSSES Attach to Form 540 or S40KR Use this schedule to report gains and losses on stocks, bonds and similar investments, and gains (but not losses) on personal assets such as a home or jewelry. Name ag shown on Form 5 ONR /) amuers Piytrrs Kup PART I-—Assets Hold One Yeor or Less e. Cost or other basis as adjusted, cost of subse- - quent improvements (if not purchased, attach explanation) and = ex- pense of sale c. Date sold (mo., day, yr.) f. Gain or loss _ Gd, tess e) b. Date acquired (mo., day, yr.) a. Kind of property and description (Example, 100 shares of ‘‘Z’" Co.) d. Gross sales price “LOAN Tas MMi eee a OAs HOLA TG 977 nk CO CHIEFTAINDEXEL | a3. 1640/2 ¥ Aaa << See re ee Gk 00 META AP DEVEL) if a) Melle 698 | IPE N20 D...: 2, ‘Enter. gain ‘(or ‘loss), if applicable, from line 18, Schedulo D1 (540) (attach copy) . ns 3. Enter your share of net gain or loss from partnerships and fiduciaries . ... Soe es . . 4. Net gain or loss, combine lines 1,2 and3 2 2 1 1 ee 8 ee 7TOvVeicw) i PART Il—Assets Held More Than One Year But Not More Than Five Years cepope doveesge ge ceeepereceeee de i o a iT Fe One | SfisJo2-|. : _— ie | DATA). | “& Emer gain (or loss), if applicable, from line 20, Schedule D-1 (540) (attach copy)... ee [eee eeeenene ! 7. Enter your share of net gain or loss from partnerships and fiduciaries . . b 8. Net gain or loss, combine lines 5, 6 and 7 : pant iNl—Assets Held More Than Five Years _ a ABLES BRRIMERL PP cnn neni annem Ce ‘Ce 063). ofc coef eee fee scene vn elvesvsvnnasnnneafesseenneesetseeeensetes wee te gee 10. Enter gain (or foss), if cpplicable, from line 22, Schedule D-1 (540) (attach copy) 11. Enter your share of net gain or loss from partnerships and fiduciaries . os ee mes meee een renee 12. Net gain or loss, combine lines 9, 10 and 11 : ‘ PART iV—Summary of Capital Gains and Losses i 13. Enter amount from line 4 . ‘ 14. Enter 65% of the amount on line 8 . 15, Enter 50% of the amount on line 12.0. 6 6 ee ee ‘ 16. Enter unused capital loss carryover from preceding taxable years “(attach computation f 17, Combine the amounts shown on lines 13, 14, 15 and 16 . 18, If line 17 shows a gain, enter here and on page 2, Part Il of Form 540. or '540NR 19. If line 17 shows a loss, enter here and on page 2, Part Il of Form 540 or 540NR the smallest of: i (a) amount on lines 17; (b) the taxable income for the taxable year (computed without regard to gains or losses from sale or exchange 7 of capital assets; or (c) $1,000 ($500 in the case of a husband or wife filing a separate return) 983—Deetd+ 3099-45535 —Page—-3§—-@@@ ————————