To apply, fill out the Self-Certification Unforeseeable Emergency Form (PDF) and return it to us via mail. Benefit Distribution Request (PDF) (PDF) – Start the process needed to request a distribution from the Plan.Before completing this form, read the back for important information regarding 457 Emergency Withdrawals. 2. Submit your forms as follows: 1) Inquries and questions can be sent via email to the Plan. A withdrawal while you are employed is allowed only for an unforeseeable emergency that causes a severe financial hardship. Only the amount necessary to meet. When you are ready to take money from your pre-tax account, your withdrawal will be subject to federal income taxes.