Form Nc-4 - Employee'S Withholding Allowance Certificate, Nc-4p Allowance Worksheet 2015


Employee’s Withholding
Allowance Certificate
PURPOSE - Complete Form NC-4, Employee’s Withholding Allowance
HEAD OF HOUSEHOLD - Generally you may claim head of household
Certificate, so that your employer can withhold the correct amount of
status on your tax return only if you are unmarried and pay more than
State income tax from your pay. If you do not provide an NC-4 to your
50% of the costs of keeping up a home for yourself and your dependent(s)
employer, your employer is required to withhold based on single with
or other qualifying individuals. Note: “Head of Household” for State tax
zero allowances.
purposes is the same as for federal tax purposes.
FORM NC-4 EZ - You may use this form if you intend to claim either:
exempt status, or the N.C. standard deduction and no tax credits or only
QUALIFYING WIDOW(ER) - You may claim qualifying widow(er) status
the credit for children.
only if your spouse died in either of the two preceding tax years and you
meet the following requirements:
FORM NC-4 NRA - If you are a nonresident alien you must use Form NC-4
Your home is maintained as the main household of a child or stepchild
FORM NC-4 BASIC INSTRUCTIONS - Complete the Allowance
for whom you can claim a federal exemption; and
Worksheet. The worksheet will help you figure the number of withholding
You were entitled to file a joint return with your spouse in the year of
allowances you are entitled to claim.
The worksheet is provided for
your spouse’s death.
employees to adjust their withholding allowances based on N.C. itemized
deductions, federal adjustments to income, N.C. additions to federal
adjusted gross income, N.C. deductions from federal adjusted gross
MARRIED TAXPAYERS - For married taxpayers, both spouses must agree
income, and N.C. tax credits. However, you may claim fewer allowances
as to whether they will each complete the Allowance Worksheet based on
if you wish to increase the tax withheld during the year. If your withholding
married filing jointly or married filing separately.
allowances decrease, you must file a new NC-4 with your employer within
10 days after the change occurs. Exception: When an individual ceases to
be head of household after maintaining the household for the major portion
For married taxpayers completing the Allowance Worksheet based
of the year, a new NC-4 is not required until the next year.
on married filing jointly, you will consider the sum of both spouses
incomes, adjustments, additions, deductions, and credits on the
TWO OR MORE JOBS - If you have more than one job, figure the total
Allowance Worksheet to determine the number of allowances.
number of allowances you are entitled to claim on all jobs using one Form
NC-4 Allowance Worksheet. Your withholding will usually be most accurate
when all allowances are claimed on the NC-4 filed for the higher paying job
For married taxpayers completing the worksheet on the basis of
and zero allowances are claimed for the other. You should also refer to the
married filing separately, each spouse will consider only his or her
Multiple Jobs Table to determine the additional amount to be withheld on
portion of income, adjustments, additions, deductions, and credits on
line 2 of Form NC-4 (See Allowance Worksheet).
the Allowance Worksheet to determine the number of allowances.
NONWAGE INCOME - If you have a large amount of nonwage income,
such as interest or dividends, you should consider making estimated tax
All NC-4 forms are subject to review by the North Carolina Department
payments using Form NC-40 to avoid underpayment of estimated tax
of Revenue. Your employer may be required to send this form to the
interest. Form NC-40 is available on our website at under
individual income tax forms.
North Carolina Department of Revenue.
CAUTION: If you furnish an employer with an Employee’s Withholding Allowance Certificate that contains information which has no
reasonable basis and results in a lesser amount of tax being withheld than would have been withheld had you furnished reasonable
information, you are subject to a penalty of 50% of the amount not properly withheld.
Cut here and give this certificate to your employer. Keep the top portion for your records.
Employee’s Withholding Allowance Certificate
North Carolina Department of Revenue
1. Total number of allowances you are claiming
(Enter zero (0), or the number of allowances from Page 2, line 16 of the NC-4 Allowance Worksheet)
Additional amount, if any, withheld from each pay period (Enter whole dollars)
Social Security Number
Marital Status
Head of Household
Married or Qualifying Widow(er)
First Name
Last Name
(Enter first five letters)
Zip Code (5 Digit)
Country (If not U.S.)
Employee’s Signature
I certify, under penalties provided by law, that I am entitled to the number of withholding allowances claimed on line 1 above.


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