Get Hardship Withdrawal Request Form

Filling out the Hardship Withdrawal Request Form online can be a straightforward process if you follow the necessary steps. This guide aims to provide clear instructions on how to accurately complete each section of the form to ensure your request is submitted smoothly.

Follow the steps to complete your hardship withdrawal request effectively.

1. Click ‘Get Form’ button to obtain the Hardship Withdrawal Request Form and open it in your preferred editor.
2. Section A requires you to fill in the Plan Information. Enter your group number and plan name as specified by your employer's plan documents.
3. Move to Section B where you will provide your Participant Information. Input your Social Security Number, your name, date of birth, legal address, email, city, state, zip code, and daytime phone number. Note that your legal address will be used for all future correspondence.
4. In Section C, state the hardship withdrawal amount. Ensure to select a withdrawal amount that does not exceed your actual financial need, as per the guidelines outlined in the form.
5. If applicable, complete Section D for Source of Payment. Indicate if you want any withdrawal to come from your Roth contribution source and specify the percentage if desired.
6. In Section E, check the boxes that apply to the type of financial hardship you are experiencing. Be aware that supporting documentation is required for each hardship claimed.
7. If you have alternative mailing addresses, fill out Section F with the new mailing address. You may also opt for express mail or wire transfer for your payment in this section, along with any applicable fees.
8. Complete Section G by indicating your federal income tax withholding preferences. You can choose not to withhold or specify a percentage or amount for withholding.
9. For Section H, if relevant to your state, indicate your state income tax withholding preferences as required by law.
10. In Section I, you must certify and authorize the details provided in this form are accurate. This includes acknowledging the consequences of any false information.
11. Section J is designated for the Plan Administrator’s certification. This should be completed by the authorized plan representative and requires their signature.
12. Finally, ensure you have signed and dated the form at the bottom. Review all entries for accuracy before submitting.
13. Once completed, save changes, and choose an option to download, print, or share the form according to your needs.

Complete your Hardship Withdrawal Request Form online today to ensure timely processing of your request.