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HARDSHIP WITHDRAWAL REQUEST PLEASE PRINT OR TYPE PLAN NAME PARTICIPANT INFORMATION Name First Middle Last SS# — Date of Birth Home Address City State Zip Telephone: Amount of Hardship Withdrawal
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How to fill out hardship withdrawal request form

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How to fill out a hardship withdrawal request form:

01
Obtain the form: Contact your employer, human resources department, or financial institution that manages your retirement account to request the hardship withdrawal request form. They can provide you with the necessary paperwork or direct you to an online version.
02
Read the instructions: Before filling out the form, carefully read the instructions provided. The instructions will provide important guidance on how to complete the form accurately and any supporting documents that may be required.
03
Personal information: Start by filling out your personal information on the form. This typically includes your name, contact information, employee or account number, and relevant identification details.
04
Reason for withdrawal: Clearly state the reason for your hardship withdrawal. This may include medical expenses, educational expenses, prevention of eviction or foreclosure, funeral expenses, or other qualified financial hardships. Be as specific as possible in explaining the circumstances leading to your request. Provide any relevant documentation or evidence to support your claim, as required.
05
Amount requested: Indicate the amount you would like to withdraw from your retirement account. Ensure that you comply with any limitations or restrictions outlined in the instructions or plan guidelines. It's important to note that hardship withdrawals are subject to income tax and, if taken before retirement age, may also incur penalties.
06
Signature and date: Sign and date the form once you have completed all the required sections. Your signature verifies the accuracy of the information provided and your understanding of the consequences of the withdrawal.

Who needs a hardship withdrawal request form?

01
Employees facing financial hardship: Individuals who are experiencing financial difficulties and have exhausted other available resources may require a hardship withdrawal request form. This includes those who need immediate funds for medical emergencies, educational expenses, preventing eviction or foreclosure, burial or funeral expenses, or other qualified hardships.
02
Retirement account holders: Individuals who have a retirement account, such as a 401(k) or an individual retirement account (IRA), and wish to make a hardship withdrawal from their account will need to fill out a hardship withdrawal request form. The specific form required may vary depending on the institution managing the account.
03
Eligible participants: To be eligible for a hardship withdrawal, individuals must meet certain criteria outlined by their retirement plan and the Internal Revenue Service (IRS). Generally, participants need to demonstrate an immediate and significant financial need that cannot be met through other means. However, it's important to review the specific guidelines of your retirement plan to determine your eligibility.
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Hardship withdrawal request form is a form that allows individuals to request a withdrawal from their retirement account due to financial hardship.
Individuals who are experiencing financial hardship and need to access funds from their retirement account may be required to file a hardship withdrawal request form.
To fill out a hardship withdrawal request form, individuals must provide detailed information about their financial situation and the reason for the withdrawal request.
The purpose of the hardship withdrawal request form is to provide a way for individuals to access funds from their retirement account in case of financial hardship.
Information such as the reason for the withdrawal request, documentation of the financial hardship, and the amount being requested must be reported on the hardship withdrawal request form.
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