To apply, fill out the Self-Certification Unforeseeable Emergency Form (PDF) and return it to us via mail. A supplemental retirement plan that allows employees to contribute a portion of their pretax salary, within certain Internal Revenue Service (IRS) limits.Benefit Distribution Request (PDF) (PDF) – Start the process needed to request a distribution from the Plan. 4) If you have only non-refundable contributions, your only option is deferred retirement with reciprocity. You may not request a refund. If you have any questions about completing this form, or about applying for a withdrawal on your own behalf, please contact Carolina Lopez at (510) 464-6208. The policies, rules, and regulations found in this Catalog are binding on all students, as are those found in the BCC. Prices of books and pocket supplements are listed in the first Federal Register issue of each month.