DCWD-17 Rev. 5/19/2006 DC Special Tax Notice rev. 4/17/2013 SUBSTITUTE W-4P WITHHOLDING CERTIFICATE FOR URS SAVINGS PLANS 401 k 457 Roth IRA Traditional IRA. 4. Return the completed form s to Utah Retirement Systems. 401 k HARDSHIP WITHDRAWAL APPLICATION SECTION A - PARTICIPANT INFORMATION Name First Middle Last SSN or Account Mailing Address Daytime Phone Number City State Zip Employer/Department SECTION B - WITHDRAWAL REQUEST I am applying for .
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How to fill out the Urs Dcwd 17 Form online
The Urs Dcwd 17 Form is essential for individuals seeking a hardship withdrawal from their 401(k) plan within the Utah Retirement Systems. Completing this form accurately is critical for ensuring your request is processed efficiently and meets all necessary requirements.
Follow the steps to fill out the Urs Dcwd 17 Form online.
- Click ‘Get Form’ button to obtain the form and open it in your preferred online editor.
- Begin with Section A - Participant Information. Accurately enter your name, Social Security number or account number, mailing address, daytime phone number, city, state, zip code, and employer/department.
- Proceed to Section B - Withdrawal Request. Clearly indicate that you are applying for a hardship distribution from the Utah Retirement Systems 401(k) Plan. Specify the reason for your request by checking the applicable boxes and providing supporting documentation for each area checked.
- Enter the 'Amount needed' for each checked reason. Ensure the total matches the sums of the amounts entered above. Calculate the subtotal, then include any additional funds necessary to cover taxes and penalties.
- Answer the questions regarding alternative means to relieve the hardship. Each question must be answered 'Yes' or 'No' based on your unique situation.
- In Section C - Certification and Signature, read the certification statement carefully. Sign and date the form to certify that the information provided is accurate. Note if your account balance is over $5,000, you will need to sign in the presence of a Notary Public.
- Finally, review all sections of the form to ensure completeness and accuracy. Save your changes, download a copy for your records, and print or share as needed before submitting the form to Utah Retirement Systems.
Complete your Urs Dcwd 17 Form online today to initiate your hardship withdrawal!
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