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This version of the form is not currently in use and is provided for reference only. Download this version of
Form FTB3895
for the current year.
Form FTB3895 California Health Insurance Marketplace Statement - California
What Is Form FTB3895?
This is a legal form that was released by the California Franchise Tax Board - a government authority operating within California. Check the official instructions before completing and submitting the form.
FAQ
Q: What is Form FTB3895?
A: Form FTB3895 is the California Health Insurance Marketplace Statement.
Q: What is the purpose of Form FTB3895?
A: The purpose of Form FTB3895 is to provide information about health insurance coverage obtained through the California Health Insurance Marketplace.
Q: Who needs to file Form FTB3895?
A: Only California residents who obtained health insurance coverage through the California Health Insurance Marketplace need to file Form FTB3895.
Q: What information is reported on Form FTB3895?
A: Form FTB3895 reports information about the individual and the health insurance coverage obtained, including the months of coverage and the amount of any premium assistance received.
Q: When is the deadline to file Form FTB3895?
A: Form FTB3895 must be filed by the tax filing deadline, which is typically April 15th of the following year.
Q: Do I need to include Form FTB3895 with my federal tax return?
A: No, Form FTB3895 is specific to California and should not be included with your federal tax return. It should be filed with the California Franchise Tax Board separately.
Q: Is there a penalty for not filing Form FTB3895?
A: Yes, failure to file Form FTB3895 when required may result in penalties and interest assessed by the California Franchise Tax Board.
Form Details:
- The latest edition provided by the California Franchise Tax Board;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form FTB3895 by clicking the link below or browse more documents and templates provided by the California Franchise Tax Board.
