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How do I fill this out?
To fill out this form, start by providing your participant information in the designated sections. Next, detail the withdrawal amount you are requesting and specify the hardships that apply to your situation. Finally, follow the withdrawal instructions based on your investment options for an easy processing experience.

How to fill out the Equitable Hardship Withdrawal Request Form?
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1. Gather your personal information including your certificate number.
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2. Specify the total amount of hardship withdrawal you are requesting.
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3. Describe the hardship circumstances that necessitate your withdrawal.
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4. Provide instructions on how you want the withdrawal taken from your investment options.
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5. Review and submit the form as per the instructions given.
Who needs the Equitable Hardship Withdrawal Request Form?
1
Employees facing financial hardship due to medical expenses.
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Individuals requiring funds to prevent eviction or foreclosure.
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Students needing assistance to cover tuition and related costs.
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Homeowners needing to cover necessary repairs to their homes.
5
Anyone impacted by disaster-related financial burdens.
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What are the important dates for this form in 2024 and 2025?
Important dates for submitting this form include ongoing requests throughout 2024. Be aware of the specific deadlines provided by Equitable for processing withdrawals. Stay updated on any changes that may occur regarding the submission timeline.

What is the purpose of this form?
The purpose of this form is to facilitate hardship withdrawals from 403(b) TSA plans offered by Equitable. It allows participants to access their funds when faced with immediate financial needs as defined under federal tax regulations. Filling out this form correctly ensures users receive the funds necessary to alleviate their financial burdens promptly.

Tell me about this form and its components and fields line-by-line.

- 1. Participant Information: Section to provide personal and contact details such as name, address, and certificate number.
- 2. Withdrawal Amount Requested: Specifies the total amount of hardship withdrawal being requested.
- 3. Hardship Circumstances: A section where participants describe their financial hardship.
- 4. Withdrawal Instructions: Guidelines on how the requested withdrawal should be executed.
- 5. Important Tax Notification: Alerts users to federal and potential state tax withholdings related to withdrawals.
What happens if I fail to submit this form?
If the form is not submitted correctly, the withdrawal request may be denied or delayed. Participants should ensure all sections are filled out accurately to avoid any issues.
- Incomplete Information: Missing required details can result in processing delays.
- Employer Restrictions: Some employers may have specific restrictions against hardship withdrawals.
- Tax Implications: Participants should be aware of the tax implications of their requests.
How do I know when to use this form?

- 1. Medical Expenses: When needing funds for medical care expenses.
- 2. Housing Crisis: To prevent eviction or foreclosures on your home.
- 3. Educational Costs: To cover tuition and related educational expenses.
- 4. Home Repairs: For urgent home repairs due to damage or disasters.
- 5. Disaster Relief: To address needs arising from federally declared disasters.
Frequently Asked Questions
How do I start filling out the hardship withdrawal form?
Begin by gathering your personal details and identifying the hardship reasons that qualify for withdrawal.
What information do I need to provide?
You will need to provide personal information such as your name, address, and your certificate number.
Can I edit the PDF after downloading?
Yes, you can make edits to the PDF before finalizing and submitting.
How will I know if my withdrawal request is approved?
You will receive a confirmation from Equitable regarding the approval or denial of your request.
Are there any tax implications for hardship withdrawals?
Yes, federal income tax will be withheld from the withdrawal amount unless you decided otherwise.
How long does it take to process the withdrawal?
Processing times may vary, but typically you can expect a response within a few business days.
What if my employer does not allow hardship withdrawals?
If your employer does not permit hardship withdrawals, the request will not be processed.
Can I request a partial withdrawal?
Yes, you can specify the amount for a partial withdrawal in the form.
Is there a fee for processing the hardship withdrawal?
Yes, applicable withdrawal charges will be deducted from your total Annuity Account Value.
Where can I submit my completed form?
Completed forms can be submitted via fax, express mail, or regular mail to the specified Equitable addresses.
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