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  1. Click ‘Get Form’ to open it in the editor.
  2. In Section I, fill in all applicable participant information, including your name, Social Security number, and contact details.
  3. Proceed to Section II. If the withdrawal is for someone else, indicate the relationship by checking the appropriate box. For home-related expenses, ensure you certify that funds will be used for your primary residence.
  4. In Section III, select either the maximum amount available or specify a dollar amount you are requesting.
  5. Move to Section IV and make your gross-up election. You can choose to gross-up your hardship amount by up to 30% for anticipated taxes.
  6. In Section V, indicate your federal and state income tax withholding preferences.
  7. If necessary, provide any additional instructions in Section VI.
  8. Finally, sign in Section VII to authorize your hardship withdrawal request.

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You will not need to submit any documentation with your application to prove that you meet all of the qualifications to take a hardship withdrawal. As part of the application, you will certify that you meet all of the requirements to receive a hardship withdrawal.
IRA Hardship Withdrawal Rules Unreimbursed medical expenses that exceed more than 7.5% of adjusted gross income (AGI) Qualified higher education expenses. Purchasing your first home (no penalty on up to $10,000 early withdrawal) Certain expenses if youre a qualified military reservist called to active duty.
Participants may request a hardship distribution online or via an Empower Representative for up to two hardship requests per Plan year. Participants use supporting documentation to provide specific summary information when requesting a hardship and do not submit copies of the supporting documentation.
Acceptable Documentation Lost Employment. Unemployment Compensation Statement. (Note: this satisfies the proof of income requirement as well.) Termination/Furlough letter from Employer. Pay stub from previous employer with.
By proving you have little to no net disposable income with reasonable living expenses, you can meet the eligibility requirements and qualify for IRS hardship.
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A hardship withdrawal is a distribution from an employees 403(b) retirement account made because of an immediate and heavy financial need. The distribution is limited to the amount necessary to satisfy that financial need and any applicable taxes and penalties.

hardship withdrawal letter sample