Hardship Withdrawal Request | Transamerica
This file is used to request a hardship withdrawal for Appalachian Regional Healthcare employees. It includes instructions, personal and plan sponsor information, hardship withdrawal information, supporting documentation, payment options, tax withholding, and necessary signatures.
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How do I fill this out?
To fill out this form, gather required personal information, financial documentation, and necessary signatures. Follow the instructions provided in each section of the form. Ensure all required fields are completed accurately before submission.
How to fill out the Hardship Withdrawal Request | Transamerica?
1
Gather your personal information and plan sponsor details.
2
Specify the amount you wish to withdraw and the reason for the hardship withdrawal.
3
Provide supporting documentation for your financial need.
4
Choose your payment option and specify tax withholding preferences.
5
Sign the form and obtain any required spousal consent and medallion signature guarantee if applicable.
Who needs the Hardship Withdrawal Request | Transamerica?
1
Employees of Appalachian Regional Healthcare who are facing immediate and heavy financial need.
2
Individuals seeking to prevent foreclosure on or eviction from their principal residence.
3
People needing funds for the purchase of their principal residence.
4
Those with post-secondary education expenses for themselves, spouse, child, or dependents.
5
Individuals covering medical expenses or burial/funeral expenses for a deceased family member.
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1
Open the Hardship Withdrawal Request form on PrintFriendly.
2
Use the PDF editor tool to fill in personal and financial information accurately.
3
Complete all required fields and attach any necessary supporting documentation.
4
Elect your payment option and specify tax withholding preferences.
5
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What are the instructions for submitting this form?
To submit this form, complete all applicable sections and obtain any required signatures. Send the form along with supporting documentation to Transamerica, 6400 C Street SW, Cedar Rapids, IA 52499, or fax it to 833-200-9987. For questions or assistance, you can call 800-755-5801. Ensure all fields are filled accurately and supporting documents are enclosed to avoid processing delays. It is advisable to keep a copy of the form and any submitted documents for your records.
What is the purpose of this form?
The primary purpose of this form is to enable employees of Appalachian Regional Healthcare to request a hardship withdrawal due to immediate and heavy financial need. This form ensures that employees can access their Thrift Plan funds to cover significant expenses such as preventing foreclosure, paying for medical or education expenses, and other pressing financial obligations. By providing detailed information and necessary documentation, the form helps streamline the request process and ensures compliance with plan provisions. Completing this form accurately and thoroughly will help expedite the withdrawal process and ensure that employees receive the financial assistance they need in a timely manner.
Tell me about this form and its components and fields line-by-line.
- 1. Plan Sponsor Information: Includes the Plan Name, Contract/Account Number, Affiliate Number, and Division Number.
- 2. Personal Information: Includes Social Security Number, First Name, Last Name, Date of Birth, Mailing Address, City, State, Zip Code, Phone Number, Extension, and E-mail Address.
- 3. Hardship Withdrawal Information: Specifies the amount to be withdrawn and the reason for the financial need, with options for adding taxes to the distribution amount.
- 4. Supporting Documentation: Lists the types of financial needs and the corresponding documentation required to support the withdrawal request.
- 5. Payment Options: Includes options for Direct Deposit to bank account or Check, with important notes on processing times and policies.
- 6. Tax Withholding: Details federal and state income tax withholding options and requirements.
- 7. Participant Signature: Requires the participant's signature, date, printed name, and Social Security Number.
- 8. Spousal Consent: Includes the spouse's consent to waiver of survivorship benefits, signature, and date, witnessed by a Plan Sponsor or Notary Public.
What happens if I fail to submit this form?
Failure to submit this form may result in an inability to access the necessary funds to address your financial hardship. Completing and submitting the form accurately and promptly ensures you can receive the appropriate withdrawal.
- Delayed Access to Funds: You may experience delays in accessing the funds needed to address your financial situation.
- Non-Compliance: Incomplete or incorrect form submission may lead to non-compliance with plan provisions and regulatory requirements.
How do I know when to use this form?
- 1. Prevent Foreclosure or Eviction: Use this form to withdraw funds needed to prevent foreclosure on or eviction from your principal residence.
- 2. Purchase Principal Residence: Submit this form when you require funds for the purchase of your principal residence, excluding mortgage payments.
- 3. Educational Expenses: Apply for a hardship withdrawal to cover post-secondary education expenses for yourself or eligible family members.
- 4. Medical Expenses: Request a withdrawal to cover qualifying unpaid medical expenses for yourself, spouse, dependents or primary beneficiaries.
- 5. Burial/Funeral Expenses: Use the form to obtain funds to cover burial or funeral expenses for a deceased parent, spouse, child, dependent, or primary beneficiary.
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What kind of supporting documentation is required for this form?
Supporting documentation may include proof of dependency, financial needs, and relevant bills or notices.
How can I ensure my withdrawal amount is processed correctly?
Ensure all required fields are completed and supporting documentation is provided to process your withdrawal accurately.
Can I save my progress while editing the form on PrintFriendly?
Yes, save your changes as you go to ensure all information is recorded accurately.
What is a medallion signature guarantee and when is it required?
A medallion signature guarantee ensures your signature is authentic and is required for withdrawals of $150,000 or more.
How do I specify my tax withholding preferences?
You can specify your federal and state tax withholding preferences in the designated sections of the form.
Are there any costs associated with processing the hardship withdrawal?
Yes, there is a $25.00 hardship withdrawal processing fee for this transaction.
What should I do if I encounter errors while completing the form?
Ensure all required fields are filled correctly and double-check your information. Contact customer support if additional help is needed.
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