INSTRUCTIONS : EMPLOYEE’S WITHHOLDING ALLOWANCE CERTIFICATE (Form NC 4) An NC 4 form, the Employees Withholding Allowance Certificate, allows your employer to withhold the proper amount of State income tax from your pay. A new NC 4 form must be filed if your personal or financial situation changes. In this case we are using the example of the North Carolina state NC 4 form. You NC 4 form will first require that you supply your basic identification information. 1. In the top box, you will provide you social security number, your marital status, your name, and your current address. Next, in the second box, you must provide the number of allowances you are claiming and any additionally withholding amounts you want your employer to take from your paycheck. 2. Certify if you are exempt from the state income tax in the second box. In the third and fourth boxes, you must sign your name and have your employer fill out their employer identification information. 3. You must ensure that your employer fills out this section before they can submit it to the state's revenue department. On the second page, you will now identify your specific tax information in order for the state to calculate your income tax. 4. Lines A through F require that you identify your personal allowances. 5. You must identify if you are a dependent, if you have any dependents, if you are single, married, or widowed, and if you plan to itemize your deductions on your tax worksheet. Finally, you must identify your qualifying deductions, adjustments, and tax credits you will claim on your state income taxes. 6. In lines 1 through 14, follow the instructions for filling out your claimed tax adjustments. Consult with your tax preparer if you are unsure of your filing information before submitting this form to your employer. Once completed, your employer will file the NC 4 form with the state department of revenue.