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Financial Hardship Distribution Request

Financial Hardship Distribution Request

 

INSTRUCTIONS: ALABAMA FINANCIAL HARDSHIP DISTRIBUTION REQUEST (Form RSA-1 EMERG)
 
Alabama public employees who are enrolled in the state RSA-1 pension fund may use a form RSA-1 EMERG if an emergency compels them to request that funds be disbursed to help them alleviate the financial damage from an unforeseeable emergency such as sudden and unexpected injury or sickness, property loss due to weather such as flood or fire, or similarly unusual catastrophes beyond the control of the person filing. This document can be obtained from the website of the Retirement Systems of Alabama. 
 
Alabama Financial Hardship Distribution Request RSA-1 EMERG Step 1: On the first line, enter your full name.
 
Alabama Financial Hardship Distribution Request RSA-1 EMERG Step 2: On the second line, enter your street address or P.O. box number.
 
Alabama Financial Hardship Distribution Request RSA-1 EMERG Step 3: On the third line, enter your city, state and zip code.
 
Alabama Financial Hardship Distribution Request RSA-1 EMERG Step 4: On the fourth line, enter your Social Security number.
 
Alabama Financial Hardship Distribution Request RSA-1 EMERG Step 5: On the fifth line, enter your phone number.
 
Alabama Financial Hardship Distribution Request RSA-1 EMERG Step 6: On the sixth line, enter your date of birth.
 
Alabama Financial Hardship Distribution Request RSA-1 EMERG Step 7: On the seventh line, enter the name and address of your employer.
 
Alabama Financial Hardship Distribution Request RSA-1 EMERG Step 8: In the next section, enter the dollar amount of compensation you are requesting.
 
Alabama Financial Hardship Distribution Request RSA-1 EMERG Step 9: Skip to the second page and read the guidelines concerning legitimate distribution of RSA-1 funds. You are required to provide a full written explanation of the nature of your emergency. Attach additional sheets if you need more space. Attach all documentation concerning your emergency.
 
Alabama Financial Hardship Distribution Request RSA-1 EMERG Step 10: Print your name at the bottom of the page.
 
Alabama Financial Hardship Distribution Request RSA-1 EMERG Step 11: Sign and date the bottom of the second page.
 
Alabama Financial Hardship Distribution Request RSA-1 EMERG Step 12: Return to the first page. You must sign and date this page in the presence of a notary public.
 
Alabama Financial Hardship Distribution Request RSA-1 EMERG Step 13: Submit the request form to the address given at the top of the first page. 
 
 

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