North Carolina W4

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NC - W4
NC-4 Empoyee's Withholding Allowance Certificate

NCDOR (Web 11-24)
1. Total number of allowances you are claiming (Enter zero (0), or the number of allowances from Page 2, Line 17 of the NC-4 Allowance Worksheet)
2. Additional amount, if any, you want withheld from each pay period (Enter whole dollars)
Social Security Number
Filing Status

Single or Married Filing SeparatelyHead of HouseholdMarried Filing Jointly or Surviving Spouse
USE CAPITAL LETTERS FOR YOUR NAME AND ADDRESS
First Name
MI
Last Name
Address

Street Address

County (First five letters)

CityState

Zip CodeCountry
Email
example@example.com
Employees 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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Date

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Date
NC-4 Allowance Worksheet - Part 1

Answer all of the following questions for your filing status.

Single

	Yes	No
1. Will your N.C. itemized deductions from Page 3, Schedule 1 exceed $15,249?
2.Will your N.C. child deduction amount from Page 3, Schedule 2 exceed $2,499?
3. Will you have federal adjustments or N.C. deductions from income?
4. Will you be able to claim any N.C. tax credits or tax credit carryovers?

If you answered "No" to all of the above, STOP HERE and enter ZERO (0) as total allowances on Form NC-4, Line 1. If you answered "Yes" to any of the above, you may choose to go to Page 2, Part II to determine if you qualify for additional allowances. Otherwise, enter ZERO (0) on Form NC-4, Line 1.

Married Filing Jointly

	Yes	No
1. Will your N.C. itemized deductions from Page 3, Schedule 1 exceed $27,999?
2. Will your N.C. child deduction amount from Page 3, Schedule 2 exceed $2,499?
3. Will you have federal adjustments or N.C. deductions from income?
4. Will you be able to claim any N.C. tax credits or tax credit carryovers?
5. Will your spouse receive combined wages and taxable retirement benefits of less than $10,250 or only retirement benefits not subject to N.C. income tax?

If you answered "No" to all of the above, STOP HERE and enter ZERO (0) as total allowances on Form NC-4, Line 1. If you answered "Yes" to any of the above, you may choose to go to Page 2, Part II to determine if you qualify for additional allowances. Otherwise, enter ZERO (0) on Form NC-4, Line 1.

Married Filing Separately

	Yes	No
1.Will your portion of N.C. itemized deductions from Page 3, Schedule 1 exceed $15,249?
2. Will your N.C. child deduction amount from Page 3, Schedule 2 exceed $2,499?
3. Will you have federal adjustments or N.C. deductions from income?
4. Will you be able to claim any N.C. tax credits or tax credit carryovers?

If you answered "No" to all of the above, STOP HERE and enter ZERO (0) as total allowances on Form NC-4, Line 1. If you answered "Yes" to any of the above, you may choose to go to Page 2, Part II to determine if you qualify for additional allowances. Otherwise, enter ZERO (0) on Form NC-4, Line 1.

Head of Household

	Yes	No
1. Will your N.C. itemized deductions from Page 3, Schedule 1 exceed $21,624?
2. Will your N.C. child deduction amount from Page 3, Schedule 2 exceed $2,499?
3. Will you have federal adjustments or N.C. deductions from income?
4. Will you be able to claim any N.C. tax credits or tax credit carryovers?

If you answered "No" to all of the above, STOP HERE and enter ZERO (0) as total allowances on Form NC-4, Line 1. If you answered "Yes" to any of the above, you may choose to go to Page 2, Part II to determine if you qualify for additional allowances. Otherwise, enter ZERO (0) on Form NC-4, Line 1.

Surviving Spouse

	Yes	No
1. Will your N.C. itemized deductions from Page 3, Schedule 1 exceed $27,999?
2. Will your N.C. child deduction amount from Page 3, Schedule 2 exceed $2,499?
3. Will you have federal adjustments or N.C. deductions from income?
4. Will you be able to claim any N.C. tax credits or tax credit carryovers?

If you answered "No" to all of the above, STOP HERE and enter ZERO (0) as total allowances on Form NC-4, Line 1. If you answered "Yes" to any of the above, you may choose to go to Page 2, Part II to determine if you qualify for additional allowances. Otherwise, enter ZERO (0) on Form NC-4, Line 1.
NC-4 Allowance Worksheet - Part 2

Skip to Page 3 Schedule 1 before filling out this section
1.Enter your total estimated N.C. itemized deductions from Page 3, Schedule 1
2. Enter the applicable N.C. standard deduction based on your filing status
3. Subtract Line 2 from Line 1. If Line 1 is less than Line 2, enter ZERO (0)
4.Enter an estimate of your total N.C. child deduction amount from Page 3, Schedule 2
5.Enter an estimate of your total federal adjustments to income and N.C. deductions from federal adjusted gross income
6.Add Lines 3, 4, and 5
7. Enter an estimate of your nonwage income (such as interest or dividends) 8.Enter an estimate of your N.C. additions to federal adjusted gross income
8. Enter an estimate of your N.C. additions to federal adjusted gross income
9. Add Lines 7 and 8
10. Subtract Line 9 from Line 6 (Do not enter less than zero, if less than 0 replace number with 0)
11. Divide the amount on Line 10 by $2,500. Round down to whole number Ex. $3,900 $2,500 = 1.56 rounds down to 1
12. Enter the amount of your estimated N.C. tax credits
13. Divide the amount on Line 12 by $109. Round down to whole number Ex. $200 $109 = 1.83 rounds down to 1
14. If filing as Single, Head of Household, or Married Filing Separately, enter zero (0) on this line.

If filing as Surviving Spouse, enter 5.

If filing as Married Filing Jointly, enter the appropriate number from either (a), (b), (c), (d), (e), or (f) below.

(a)Your spouse expects to have combined wages and taxable retirement benefits of less than or equal to $250 for N.C. purposes, enter 5. (Taxable retirement benefits do not include: Bailey, Certain Military Retirement, Social Security, and Railroad retirement)

(b)Your spouse expects to have combined wages and taxable retirement benefits of more than $250 but less than or equal to $2,750, enter 4.

(c)Your spouse expects to have combined wages and taxable retirement benefits of more than $2,750 but less than or equal to $5,250, enter 3.

(d)Your spouse expects to have combined wages and taxable retirement benefits of more than $5,250 but less than or equal to $7,750, enter 2. (e)Your spouse expects to have combined wages and taxable retirement benefits of more than $7,750 but less than or equal to $10,250, enter 1.
14. (f) Your spouse expects to have combined wages and taxable retirement benefits of more than $10,250 enter 0
15. Add Lines 11, 13, and 14, and enter the total here
16 If you completed this worksheet on the basis of Married Filing Jointly the total number of allowances determined on Line 15 may be split between you and your spouse however you choose Enter the number of allowances from Line 15 that your spouse plans to claim
17. Subtract Line 16 from Line 15 and enter the total number of allowances here and on Line 1 of your Form NC-4, Employee's Withholding Allowance Certificate
PAGE 3
Schedule 1 - Estimated N.C. Itemized Deductions
Home Mortgage Interest
Real Estate Property Taxes
Total Home Mortgage Interest and Real Estate Property Taxes*
*The sum of your home mortgage interest and real estate property taxes may not exceed $20,000. For married taxpayers,the $20,000 limitation applies to the combined total of home mortgage interest and real estate property taxes claimed byboth spouses, rather than to each spouse separately.
Charitable Contributions (Same as allowed for federal purposes)
Medical and Dental Expenses (Same as allowed for federal purposes)
Repayment of Claim of Right Income
Total Estimated N.C. Itemized Deductions. Enter on Page 2, Part II, Line 1
Schedule 2 - Estimated N.C. Child Deduction Amount

A taxpayer who is allowed a federal child tax credit under section 24 of the Internal Revenue Code is allowed a deduction for each qualifying child unless adjusted gross income exceeds the threshold amount shown below. The N.C. child deduction amount can be claimed only for a child who is under 17 years of age on the last day of the year.
Single - Adjusted Gross Income
Single - Number of Children
Single - Estimated Deduction
Married Filing Jointly or Surviving Spouse - Adjusted Gross Income
Married Filing Jointly or Surviving Spouse - Number of Children
Married Filing Jointly or Surviving Spouse - Estimated Deduction
Head of Household - Adjusted Gross Income
Head of Household - Number of Children
Head of Household - Estimated Deduction
Married Filing Separately - Adjusted Gross Income
Married Filing Separately - Number of Children
Head of Household - Estimated Deduction
NC-4 Allowance Worksheet Schedules

Important: If you cannot reasonably estimate the amount to enter in the schedules below, you should enter ZERO (0) on Form NC-4, Line 1.

Estimated N.C. Itemized Deductions

Home Mortgage Interest Real Estate Property Taxes Total Home Mortgage Interest and Real Estate Property Taxes* Charitable Contributions (Same as allowed for federal purposes) Medical and Dental Expenses (Same as allowed for federal purposes) Repayment of Claim of Right Income Total Estimated N.C. Itemized Deductions. Enter on Page 2, Part II, Line 1 *The sum of your home mortgage interest and real estate property taxes may not exceed $20,000. For married taxpayers, the $20,000 limitation applies to the combined total of home mortgage interest and real estate property taxes claimed by both spouses, rather than to each spouse separately.

Estimated N.C. Child Deduction Amount

A taxpayer who is allowed a federal child tax credit under section 24 of the Internal Revenue Code is allowed a deduction for each qualifying child unless adjusted gross income exceeds the threshold amount shown below. The N.C. child deduction amount can be claimed only for a child who is under 17 years of age on the last day of the year.

Adjusted Gross Income Up to$ 20,000 Over $ 20,000$ 30,000 Up to Over$ 30,000Up to $ 40,000 Over $ 40,000 $ 50,000 Up to Over $ 50,000 Up to $ 60,000 Over $ 60,000Up to $ 70,000 Over $ 70,000

Deduction Amount per Qualifying Child $ 3,000 $ 2,500 $ 2,000 $ 1,500 $ 1,000 500

$ 40,000 Up to $ 60,000 Over $ 40,000 Up to Over $ 60,000Up to $ 80,000 Over$ 80,000Up to $ 100,000 Over $ 100,000 Up to $ 120,000 Over$ 120,000Up to $ 140,000 Over $ 140,000

$ 3,000 $ 2,500 $ 2,000 $ 1,500 $ 1,000 500

$ 30,000 Up to Over $ 30,000$ 45,000 Up to Over $ 45,000 Up to $ 60,000 Over $ 60,000 Up to $ 75,000 Over $ 75,000 Up to $ 90,000 Over $ 90,000 Up to $ 105,000 Over $ 105,000

$ 3,000 $ 2,500 $ 2,000 $ 1,500 $ 1,000 500

Up to $20,000 $ 30,000 Over $ 20,000 Up to Over $ 30,000 Up to $ 40,000 Over $ 40,000 Up to $ 50,000 Over $ 50,000 Up to $ 60,000 Over $ 60,000 Up to $ 70,000 Over $ 70,000

$ 3,000 $ 2,500 $ 2,000 $ 1,500 $ 1,000 500
Should be Empty:

NC-4 Empoyee's Withholding Allowance Certificate

USE CAPITAL LETTERS FOR YOUR NAME AND ADDRESS

NC-4 Allowance Worksheet - Part 1

NC-4 Allowance Worksheet - Part 2

PAGE 3

Schedule 1 - Estimated N.C. Itemized Deductions

Schedule 2 - Estimated N.C. Child Deduction Amount