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North Carolina W4
EMPLOYEE’S WITHHOLDING ALLOWANCE CERTIFICATE
Download W4 Instructions
North Carolina W4
Step
1
of
3
33%
Name
*
First
Middle
Last
Email
*
Address
*
Street Address
Address Line 2
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Download W4 Instructions
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, withheld from each pay period (Enter whole dollars)
Filing Status
Single or Married Filing Separately
Head of Household
Married Filing Jointly or Surviving Spouse
Under penalties of perjury, I certify that I have examined this certificate and to the best of my knowledge and belief, it is true, correct, and complete.
*
I certify the above statement
Social Security Number
*
Employee Signature – Type Your Name
*
Today's Date
*
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My IP Address is: 44.192.115.114 This form was submitted on: 09/21/2023
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