Form NC-4 Employee's Withholding Allowance Certificate [instructions]

$3 000 if married filing separately $6 000 if married filing jointly or qualifying widow(er) 2 $80 000 head of household; $50 000 married or qualifying widow(er)) and enter the result $80 000 head of household; $50 000 married or qualifying widow(er)) of tax credit enter 1 (Employer: Complete below only if sending to the North Carolina Department of Revenue Submit the original and keep a copy for your records ) (See Form NC 4 Instructions before completing this form) 11 If you are entitled to tax credits for each $175 ($140 if you expect your income from all 12 that your spouse will claim 13 14 Subtract line 13 from line 12 and enter the total here and on line E of the Personal Allowances Worksheet 14 A Enter 1 for yourself if no one else can claim you as a dependent A Add lines 10 and 11 and enter total here 12 Add lines 3 and 4 5 Add lines 6 and 7 8 additional allowance 11 Additional withholding allowances may be claimed if you expect to have allowable itemized deductions exceeding the standard deduction Enter an estimate of the total itemized deductions to be claimed on your federal tax return less the amount of any State income tax included in your federal deductions 1 B Enter 1 if you are married and you expect your spouse s wages to be from $1 000 to $3 500 Enter 2 if you are married and your spouse has no income or expects to earn less than $1 000 B C Enter 1 if you are a qualifying widow(er) C D Enter the number of dependents (other than your spouse or yourself) you will claim on your tax return D Deductions Adjustments and Tax Credits Worksheet Divide the amount on line 9 by $2 500 ($2 000 if you expect your income from all sources for E If you plan to itemize claim adjustments to income or have allowable tax credits and want to reduce your withholding complete the Deductions Adjustments and Tax Credits Worksheet below and enter number from line 14 E Enter $4 400 if head of household $3 000 if single Enter an estimate of your federal adjustments to income and your State deductions from federal adjusted gross income 4 Enter an estimate of your nonwage income (such as dividends or interest) 6 Enter an estimate of your State additions to federal adjusted gross income 7 F Add lines A through E and enter total here and on line 1 of your Employee s Withholding Allowance Certificate F here Drop any fraction 10 If you completed this worksheet on the basis of married filing jointly enter the number from line IN ADDITION TO A ABOVE: NC 4 Employee s Withholding North Carolina Department of Revenue Page 2 Personal Allowances Worksheet sources for the year to equal or exceed the following amounts for your filing status: $60 000 single; Subtract line 2 from line 1 enter the result here 3 Subtract line 8 from line 5 9 the year to equal or exceed the following amounts for your filing status: $60 000 single; Web Allowance Certificate Your Last Name (First 10 Characters) Your Social Security Number