This version of the form is not currently in use and is provided for reference only. Download this version of Form FTB3853 for the current year.
This is a legal form that was released by the California Franchise Tax Board - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form FTB3853?
A: Form FTB3853 is a California tax form used to report health coverage exemptions and individual shared responsibility penalty.
Q: What are health coverage exemptions?
A: Health coverage exemptions are reasons that qualify an individual for an exemption from having to have health insurance as required by the Affordable Care Act.
Q: What is the individual shared responsibility penalty?
A: The individual shared responsibility penalty is a penalty imposed on individuals who did not have health insurance coverage for themselves or their dependents.
Q: Who needs to file Form FTB3853?
A: California residents who had a coverage exemption or owe an individual shared responsibility penalty need to file Form FTB3853.
Q: When is the deadline to file Form FTB3853?
A: The deadline to file Form FTB3853 is generally April 15th of the following year.
Q: What information do I need to complete Form FTB3853?
A: You will need to provide information about your health coverage exemption or individual shared responsibility penalty, including any supporting documentation.
Q: Can I e-file Form FTB3853?
A: No, Form FTB3853 can only be filed by mail.
Q: What happens if I fail to file Form FTB3853?
A: If you fail to file Form FTB3853, you may be subject to penalties and interest on any unpaid individual shared responsibility penalty.
Form Details:
Download a fillable version of Form FTB3853 by clicking the link below or browse more documents and templates provided by the California Franchise Tax Board.