Forms and applications listed here are only a portion of those available. Visit your local MDHHS Office for forms or applications not available online.Cancel or withdraw your application up to 12 months after your benefit approval. You can only cancel your application once and can reapply later. 1. Review the Unforeseeable Emergency Requirements to determine if you are ELIGIBLE to take a unforeseeable emergency withdrawal. 2. Use this form if you have terminated employment and would like to withdraw your contributions on account with the State Employees' Retirement System. Review and complete Unforeseeable Emergency Requirements to determine if you are ELIGIBLE to take an unforeseeable emergency withdrawal. Your attorney will likely file a formal motion with the court requesting permission to withdraw the plea. This motion should outline the reasons for withdrawal. If you wish to opt out of state withholding, you will need to complete the MI W-4P form and send it with your disbursement request.