Form NC-4P Withholding Certificate for Pension or Annuity Payments

Cut here and give this certificate to your employer Keep the top portion for your records $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 11 If you are entitled to tax credits for each $175 ($140 if you expect your income from all 12 Add lines 10 and 11 and enter total here 12 12 that your spouse will claim 13 13 If you completed this worksheet on the basis of married filing jointly enter the number from line 14 Subtract line 13 from line 12 and enter the total here and on line E of the Personal Allowances Worksheet 14 4P that does not contain the taxpayer identificationnumber or if the identification number is incorrect A Enter 1 for yourself if no one else can claim you as a dependent A 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 pension or 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 Caution: There are penalties for not paying enough tax during the year either through withholding or estimated tax payments New retirees especially should see Form NC 40 Individual Estimated Income Tax for details on the estimated income tax requirements You may be able to avoid quarterly estimated income tax payments by having enough tax withheld from your pension or annuity using Form NC 4P Check here if you do not want any State income tax withheld from your pension or annuity (Do not complete lines 2 or 3 ) Total number of allowances and marital status you are claiming for withholding from each periodic pension or annuity payment (You may also designate an additional dollar amount on line 3 ) 2 1 Complete the following applicable lines: Marital status: Single Married or Qualifying Widow(er) Head of Household (Enter number of allowances) Your Signature Date Additional amount if any you want withheld from each pension or annuity payment Note: For periodic payments you cannot enter an amount here without entering the number (including zero) of allowances on line 2 3 $ CHOICE If you previously chose not to have State income tax withheld on either periodic or nonperiodic payments complete another NC 4Pand submit to your payer Write Revoked next to the check box on line 1 of the form and tax will be withheld at the rate set by law City or town state and ZIP code 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 on page 2 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 income not subject to withholding (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 2 of Withholding Certificate for Pension For periodic payments your Form NC 4Pstays in effect until you change or revoke it Your payer must notify you each year of your right to choose not to have State income tax withheld or to revoke your election Form NC 4P Withholding Certificate for Pension or Annuity Payments here Drop any fraction 10 Home address (number and street or rural route) Claim or identification number (if any) of your pension or annuity contract If you furnish a pension payer a Withholding Certificate for Pension or Annuity Payments that contains information which has no reasonable basis and results in a lesser amount of tax being withheld than would have been withheld had you furnished reasonable information you are subject to a penalty of 50% of the amount not properly withheld IMPORTANT Government retirees whose income is exempt from State tax as a result of the BaileySettlement should choose no withholding by checking the box on line 1 of Form NC 4P IN ADDITION TO A ABOVE: M I S S I N G O R I N C O R R E C T TA X PAY E R IDENTIFICATION NUMBER If you submit an NC N O N P E R I O D I C D I S T R I B U T I O N S 4 % WITHHOLDING Your payer must withhold a fla t 4 % fro m a nonp erio dic d i strib ut i on unless you choose not to have income tax withheld A nonperiodic distribution means any distribution which is not a periodic payment (The 4% withholding is required on eligible rollover distributions and you cannot choose not to have income tax withheld from those distributions ) Distributions from an IRA that are payable on demand are treated as nonperiodic distributions The election to withhold from nonperiodic distributions applies on a distribution by distribution basis If you choose not to have tax withheld from a nonperiodic distribution you should check the box on line 1 of Form NC 4P and submit the completed form to your payer North Carolina Department of Revenue or Annuity Payments F Page 2NC 4P Web PERIODIC PAYMENTS Withholding from periodic payments of a pension or annuity is figured in the same manner as withholding from wages Periodic payments are made in installments at regular intervals over a period of more than one year They may be paid annually quarterly monthly etc If you want State income tax withheld you should complete the Personal Allowances Worksheet below and enter the result on line 2 of Form NC 4P You can designate an additional amount to be withheld on line 3 Submit the completed form to your payer If you do not submit Form NC 4P to your payer the payer must withhold on periodic payments as if you are married claiming three withholding allowances Personal Allowances Worksheet PURPOSE Form NC 4P is for North Carolina residents who are recipients of income from pensions annuities and certain other deferred compensation plans Use the form to tell payers whether you want any State income tax withheld and on what basis You can also use the form to choose not to have State income tax withheld However you cannot make this choice for eligible rollover distributions The method and rate of withholding depends on whether the payment you receive is a periodic payment or a nonperiodic distribution This form is also to be used by a nonresident with a North Carolina address to indicate that no tax is to be withheld from pension payments R E V O K I N G Y O U R N O W I T H H O L D I N G sources for the year to equal or exceed the following amounts for your filing status: $60 000 single; $80 000 head of household; $50 000 married or qualifying widow(er) of tax credit enter 1 Subtract line 2 from line 1 enter the result here 3 Subtract line 8 from line 5 9 the payer cannot honor your request not to have income tax withheld The payer must withhold on periodic payments as if you are married claiming three withholding allowances Withholding on nonperiodic distributions will be at the 4% rate the year to equal or exceed the following amounts for your filing status: $60 000 single; Type or print your first name and middle initial Last name Your social security number Web North Carolina Department of Revenue Withholding Certificate for NC 4P Pension or Annuity Payments