Form Nc -4 - Employee'S Withholding Allowance Certificate
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1
2FORM
(Rev. 6•95)
PURPOSE. Complete Form NC• 4 so that your
3. When an individual ceases to be head of
$2,500 and you are entitled to a standard
employer can withhold the correct amount of
household after maintaining the household
deduction of $5,000, you may elect to claim an
State income tax from your pay. EXEMPTION
for the major portion of the year.
additional personal withholding allowance on
FROM WITHHOLDING. Read line 6 of the
line C below to avoid having too much tax
HEAD OF HOUSEHOLD. Generally you may
certificate below to see if you can claim exempt
withheld.
claim head of household status on your tax return
status. If exempt, only complete the certificate;
only if you are unmarried and pay more than 50%
but do not complete lines 4 and 5. No State
MARRIED AND SPOUSE DOES NOT
of the costs of keeping up a home for yourself and
income tax will be withheld from your pay.
WORK OR HAS WAGE INCOME OF LESS
your
dependent(s)
or
other
qualifying
THAN $3,500. The withholding tax tables are
BASIC INSTRUCTIONS.
If you are not
individuals. Note: ‘‘Head of Household” for
based on both spouses earning wages during the
exempt, complete the Personal Allowances
State tax purposes is the same as for federal tax
year. If your spouse does not work or will earn
Worksheet. An additinal worksheet is provided
purposes.
wages of less than $3,500 during the year, you
on page 2 for employees to adjust their
may elect to complete line B below to avoid
withholding allowances based on itemized
QUALIFYING WIDOW(ER). You may claim
having too much tax withheld.
deductions, adjustments to income, or tax credits.
qualifying widow(er) status only if your spouse
The worksheets will help you figure the number
died in either of the two preceding tax years and
TWO JOBS. If you have more than one job,
of withholding allowances you are entitled to
you meet the following requirements:
figure the total number of allowances you are
claim.
However, you may claim fewer
entitled to claim on all jobs using only one form
1. Your home is maintained as the main
allowances if you wish to increase the tax
NC• 4. This total should be divided among all
household of a child or stepchild for whom
withheld during the year. If your withholding
jobs. Your withholding will usually be most
you can claim an exemption; and
allowances decrease, you must file a new NC• 4
accurate when all allowances are claimed on the
2. You were entitled to file a joint return with
with your employer within 10 days after the
NC• 4 filed for the higher paying job and zero
your spouse in the year of your spouse’s
change occurs except that a new NC• 4 is not
allowances are claimed for the other.
death.
required until the next year in the followng cases:
1. When a dependent dies during the year.
Note: ‘‘Qualifying Widow(er)” for State tax
NONWAGE INCOME. If you have a large
2. When an individual ceases to be a dependent
purposes is the same as for federal tax purposes.
amount of nonwage income, such as interest or
during the year and the support furnished will
Because the standard deduction used in the tax
dividends, you may be required to make
be the chief support for the year.
tables for married and qualifying widow(er) is
estimated tax payments using Form NC• 40.
P ers onal Allowances Works heet
IN ADDIT ION T O A. AB OVE :
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Important:
You s hould review your Withholding Allowance Certificate each year for any neces s ary
changes to ins ure proper withholding.
. . . . . . . . . . . . . . . . . . . . . .
Cut here and give this certificate to your employer. Keep the top portion for your records
. . . . . . . . . . . . . . . . . . . . . . .
234-5 $436)2 (74-82- 30 492:
E mployee’s Withholding Allowance Certificate
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Note
F ull•time s tudents are not automatically exempt)
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E mployee’s s ignature
Date
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E mployer:
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