INSTRUCTIONS: ALABAMA FINANCIAL HARDSHIP DISTRIBUTION REQUEST RSA-1 DEFERRED COMPENSATION PLAN (Form RSA-1 EMERG)

When Alabama public employees enrolled in the state-administered RSAI-1 deferred compensation plan experience an unexpected financial hardship, they may used the form discussed in this article to request an emergency distribution from their funds. Such withdrawals are permitted only to the extent reasonably needed to resolve the emergency situation. This document can be obtained from the website maintained by the Retirement Systems of Alabama.

Alabama Financial Hardship Distribution Request RSA-1 Deferred Compensation Plan RSA-1 EMERG Step 1: On the first blank line, enter your first name, middle or maiden name and last name.

Alabama Financial Hardship Distribution Request RSA-1 Deferred Compensation Plan RSA-1 EMERG Step 2: On the second blank line, enter your street address or P.O. box number.

Alabama Financial Hardship Distribution Request RSA-1 Deferred Compensation Plan RSA-1 EMERG Step 3: On the third blank line, enter your city, state and zip code.

Alabama Financial Hardship Distribution Request RSA-1 Deferred Compensation Plan RSA-1 EMERG Step 4: On the fourth blank line, enter your Social Security number.

Alabama Financial Hardship Distribution Request RSA-1 Deferred Compensation Plan RSA-1 EMERG Step 5: On the fifth blank line, enter your phone number.

Alabama Financial Hardship Distribution Request RSA-1 Deferred Compensation Plan RSA-1 EMERG Step 6: On the sixth blank line, enter your date of birth.

Alabama Financial Hardship Distribution Request RSA-1 Deferred Compensation Plan RSA-1 EMERG Step 7: On the seventh blank line, enter your employer's name and address.

Alabama Financial Hardship Distribution Request RSA-1 Deferred Compensation Plan RSA-1 EMERG Step 8: Skip to the second page. Here, a space is provided for you to explain the full nature of your emergency. If necessary, you may attach additional sheets. Documentation must be attached to substantiate your request. Qualifying financial hardships include sudden and unexpected illness or accident, loss of property due to flood, fire or windstorm, or other similar extraordinary and unforeseeable circumstances arising from events beyond your control.

Alabama Financial Hardship Distribution Request RSA-1 Deferred Compensation Plan RSA-1 EMERG Step 9: Return to the first page. Enter your signature and the date where indicated.

Alabama Financial Hardship Distribution Request RSA-1 Deferred Compensation Plan RSA-1 EMERG Step 10: Appear before a notary public, who will affix their seal to certify this form.