FTB 3853 Health Coverage Exemptions Instructions 2022
The FTB 3853 form provides California residents with information on health coverage exemptions and penalties. This guide helps you understand your responsibilities and options regarding health coverage. Follow these instructions to ensure you comply with California's minimum essential coverage mandate.
Edit, Download, and Sign the FTB 3853 Health Coverage Exemptions Instructions 2022
Form
eSign
Add Annotation
Share Form
How do I fill this out?
To fill out the FTB 3853 form, gather your health coverage documents and applicable household information. Carefully read the instructions to determine your eligibility for exemptions or penalties. Fill in the required fields accurately to avoid issues with your state tax return.

How to fill out the FTB 3853 Health Coverage Exemptions Instructions 2022?
1
1. Collect all necessary health coverage documentation.
2
2. Determine if you or household members qualify for any exemptions.
3
3. Fill out the applicable sections of the FTB 3853 form.
4
4. Review your entries for accuracy and completeness.
5
5. Submit the form along with your tax return.
Who needs the FTB 3853 Health Coverage Exemptions Instructions 2022?
1
1. California residents who did not maintain health coverage for the entire year.
2
2. Individuals claiming a health coverage exemption.
3
3. Taxpayers needing to calculate their Individual Shared Responsibility Penalty.
4
4. Dependents who need to verify their health coverage status.
5
5. Registered Domestic Partners (RDPs) seeking to report their health coverage.
How PrintFriendly Works
At PrintFriendly.com, you can edit, sign, share, and download the FTB 3853 Health Coverage Exemptions Instructions 2022 along with hundreds of thousands of other documents. Our platform helps you seamlessly edit PDFs and other documents online. You can edit our large library of pre-existing files and upload your own documents. Managing PDFs has never been easier.

Edit your FTB 3853 Health Coverage Exemptions Instructions 2022 online.
Edit your FTB 3853 PDF using our intuitive editing tools on PrintFriendly. Make adjustments to your information directly on the document without hassle. Simply save the edited version for your records or for submission.

Add your legally-binding signature.
Signing your FTB 3853 PDF on PrintFriendly is easy with our built-in signature feature. Add your signature electronically and ensure your document is ready for submission. This convenient option eliminates the need for printing and scanning.

Share your form instantly.
Easily share your FTB 3853 PDF with others using PrintFriendly’s sharing capabilities. Send the document via email or share it directly through your preferred social media channels. Sharing has never been more straightforward.
How do I edit the FTB 3853 Health Coverage Exemptions Instructions 2022 online?
Edit your FTB 3853 PDF using our intuitive editing tools on PrintFriendly. Make adjustments to your information directly on the document without hassle. Simply save the edited version for your records or for submission.
1
1. Open the FTB 3853 PDF on PrintFriendly.
2
2. Click the 'Edit' option to start modifying your document.
3
3. Input your required information in the designated fields.
4
4. Review your changes carefully to ensure accuracy.
5
5. Save and download the edited PDF for your records.

What are the instructions for submitting this form?
To submit Form FTB 3853, include it with your California tax return by the filing deadline. You can submit this form electronically through the California Franchise Tax Board's e-file portal, or you may choose to mail a physical copy to the designated address listed in the instructions. Make sure to keep a copy for your records and follow all specific submission guidelines to ensure accurate processing.
What are the important dates for this form in 2024 and 2025?
The deadlines for filing Form FTB 3853 coincide with tax return filing deadlines, typically April 15 for the previous tax year's returns. In 2024 and 2025, ensure to stay updated as forms and requirements can change annually. It's essential to check the California Franchise Tax Board website for any updates regarding deadlines for health coverage exemptions.

What is the purpose of this form?
Form FTB 3853 serves to ensure that California residents comply with the health coverage requirement mandated by state law. The form allows individuals to report their qualifying health coverage, claim exemptions, and avoid penalties associated with non-compliance. Completing this form accurately is vital for both tax filing and maintaining compliance with California health insurance regulations.

Tell me about this form and its components and fields line-by-line.

- 1. Applicable Household Members: Information about each individual in the household concerning their health coverage status.
- 2. Exemptions Claimed: Details on any exemptions claimed by household members.
- 3. Individual Shared Responsibility Penalty: Calculations for any penalties due based on health coverage compliance.
What happens if I fail to submit this form?
Failing to submit Form FTB 3853 may result in penalties imposed on the taxpayer for non-compliance with the state's health coverage mandate. In addition, not filing could lead to missed exemptions that may have reduced tax penalties. It's crucial to ensure timely submission to avoid unnecessary financial consequences.
- Penalties for Non-compliance: Individuals who do not submit the form may incur penalties associated with failing to maintain minimum essential coverage.
- Inaccurate Reporting: Not filing properly may lead to discrepancies in tax filings and potential audits.
- Lost Exemptions: Without submission, taxpayers may miss out on claiming valid exemptions and reduce potential tax liabilities.
How do I know when to use this form?

- 1. Reporting Exemptions: To report any health coverage exemptions for yourself or household members.
- 2. Calculating Penalties: When you need to calculate the Individual Shared Responsibility Penalty.
- 3. Tax Filing Requirement: To comply with California state tax laws regarding health coverage mandates.
Frequently Asked Questions
What is Form FTB 3853?
Form FTB 3853 is used by California residents to report health coverage exemptions and calculate any shared responsibility penalties.
Who should fill out Form FTB 3853?
California residents who did not maintain health coverage, wish to claim exemptions, or need to calculate penalties must complete this form.
How can I edit my PDF using PrintFriendly?
Simply upload your FTB 3853 PDF, click 'Edit', and make your changes directly on the document.
Can I share the edited PDF?
Yes, PrintFriendly allows you to easily share your edited FTB 3853 PDF via email or social media.
Is there a deadline for submitting Form FTB 3853?
Yes, it's important to submit Form FTB 3853 along with your California tax return by the tax filing deadline.
What happens if I don't submit Form FTB 3853?
Failing to submit Form FTB 3853 may result in penalties if you or your household did not maintain health coverage.
Where can I find instructions for filling out Form FTB 3853?
Instructions are included with the form itself and provide detailed guidance on completing it accurately.
What information is required to fill out the form?
You will need personal information, details on your health coverage status, and any relevant exemption certificates.
Can I file Form FTB 3853 online?
Yes, after completing the form, you can submit it electronically with your tax return.
What is the purpose of Form FTB 3853?
The purpose is to determine compliance with California's health coverage mandate and assess any penalties for non-compliance.
Related Documents - FTB 3853

Residential Lease Agreement Checklist for Tenants and Landlords
This document provides a detailed checklist of what both tenants and landlords need to know and include in a residential lease agreement. It covers key elements such as lease terms, rent payment schedules, and maintenance responsibilities. Use this guide to ensure all rights and obligations are clearly outlined in your lease agreement.

Residential Lease or Month-to-Month Rental Agreement
This file contains a comprehensive residential lease or month-to-month rental agreement used in California. It provides details on terms, obligations, and conditions for both landlords and tenants. Perfect for those seeking a standardized rental agreement form.

Civil Court of the City of New York Nonpayment Petition
This document is a Notice of Nonpayment Petition issued by the Civil Court of the City of New York. It details the actions that a landlord can take against a tenant for nonpayment of rent. It includes instructions on how the tenant can respond and their rights.

Form 1099-MISC: Miscellaneous Income for 2013
This file is a 2013 version of the IRS Form 1099-MISC used to report miscellaneous income. It includes fields for reporting various types of payments made to individuals or entities. The form is typically filed by payers to report income paid to recipients.

Instructions for Form 706 (Rev. September 2023)
This document provides detailed instructions for completing Form 706, the United States Estate (and Generation-Skipping Transfer) Tax Return for decedents dying after December 31, 2022. It includes information on revisions, general instructions, and specific filing requirements. The instructions also cover important updates and reminders related to the form.

PhilHealth Report of Employee-Members Form Instructions
This file provides instructions for employers on how to fill out and submit the PhilHealth Report of Employee-Members form. It is essential for employers to report new hires to PhilHealth to ensure proper coverage. Detailed instructions and requirements are included.

Copyright Registration Form TX Instructions
This form is used for the registration of nondramatic literary works, such as fiction, nonfiction, poetry, textbooks, and computer programs. It provides detailed information on how to complete the form, including what information is required for each section and how to submit the application. Use it to ensure your work is properly registered for copyright protection.

Plaintiff's Claim and Instructions for Small Claims Court
This file provides instructions and necessary forms for filing a Plaintiff's Claim in Small Claims Court. It includes details on filling out, submitting, and serving the forms. Ensure to follow the steps carefully to protect your rights.

Ohio Sales and Use Tax Contractor's Exemption Certificate
This document is the Ohio Sales and Use Tax Contractor's Exemption Certificate. Contractors use this form to claim exemptions on certain taxable goods for specified exempt uses. It's crucial for contractors working with tax-exempt entities or on tax-exempt projects.

Lease Agreement for University of Florida Premises
This lease agreement file outlines the terms and conditions for renting a property owned by the Landlord to the University of Florida Board of Trustees. It covers key aspects such as lease term, rent details, improvements, and permitted use. Ideal for landlords and tenants involved in leasing agreements.

Return of Private Foundation Form 990-PF 2023
Form 990-PF is a return for private foundations required by the IRS. It includes information on revenue, expenses, and other financial details. Avoid entering social security numbers on this form.

Application Form for Divorce Certificate - Andhra Pradesh State Wakf Board
This form is used to apply for a Divorce Certificate from the Andhra Pradesh State Wakf Board in Hyderabad. The form requires details of both bride and groom as per recorded information. It also includes fields for verification and office use only.