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Page 1 <br /> <br />NC-4 Allowance Worksheet <br />Answer all of the following questions for your filing status. <br />Part I <br /> <br /> <br /> <br /> <br />Single - <br /> <br />1. Will your N.C. itemized deductions from Page 3, Schedule 1 exceed $15,249? <br />2. Will your N.C. Child Deduction Amount from Page 3, Schedule 2 exceed $2,499? <br />3. Will you have federal adjustments or State deductions from income? <br />4. Will you be able to claim any N.C. tax credits or tax credit carryovers? <br />Yes o <br />Yes o <br />Yes o <br />Yes o <br />No o <br />No o <br />No o <br />No o <br />If you answered “No” to all of the above, STOP HERE and enter ZERO (0) as total allowances on Form NC-4, Line 1. <br />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 <br />additional allowances. Otherwise, enter ZERO (0) on Form NC-4, Line 1. <br />Married Filing Jointly - <br />1. <br />2. <br />3. <br />4. <br />5. <br />Will your N.C. itemized deductions from Page 3, Schedule 1 exceed $27,999? <br />Will your N.C. Child Deduction Amount from Page 3, Schedule 2 exceed $2,499? <br />Will you have federal adjustments or State deductions from income? <br />Will you be able to claim any N.C. tax credits or tax credit carryovers? <br />Will your spouse receive combined wages and taxable retirement benefits of <br />less than $10,250 or only retirement benefits not subject to N.C. income tax? <br />Yes o <br />Yes o <br />Yes o <br />Yes o <br />No o <br />No o <br />No o <br />No o <br />Yes o No o <br />If you answered “No” to all of the above, STOP HERE and enter ZERO (0) as total allowances on Form NC-4, Line 1. <br />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 <br />additional allowances. Otherwise, enter ZERO (0) on Form NC-4, Line 1. <br />Married Filing Separately - <br />1. Will your portion of N.C. itemized deductions from Page 3, Schedule 1 exceed $15,249? Yes <br />2. Will your N.C. Child Deduction Amount from Page 3, Schedule 2 exceed $2,499? <br />3. Will you have federal adjustments or State deductions from income? <br />4. Will you be able to claim any N.C. tax credits or tax credit carryovers? <br />Yes <br />Yes <br />Yes <br />o <br />o <br />o <br />o <br />No o <br />No o <br />No o <br />No o <br />If you answered “No” to all of the above, STOP HERE and enter ZERO (0) as total allowances on Form NC-4, Line 1. <br />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 <br />additional allowances. Otherwise, enter ZERO (0) on Form NC-4, Line 1. <br />Head of Household - <br /> <br />1. Will your N.C. itemized deductions from Page 3, Schedule 1 exceed $21,624? <br />2. Will your N.C. Child Deduction Amount from Page 3, Schedule 2 exceed $2,499? <br />3. Will you have federal adjustments or State deductions from income? <br />4. Will you be able to claim any N.C. tax credits or tax credit carryovers? <br />Yes o <br />Yes o <br />Yes o <br />Yes o <br />No o <br />No o <br />No o <br />No o <br />If you answered “No” to all of the above, STOP HERE and enter ZERO (0) as total allowances on Form NC-4, Line 1. <br />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 <br />additional allowances. Otherwise, enter ZERO (0) on Form NC-4, Line 1. <br />Docusign Envelope ID: 177AA06A-30B4-42FF-A85A-78B5A7C51DBE