Withdrawals are taxed as ordinary income. You may withdraw funds from the Program only upon: 1.Ending your employment (including termination, retirement, or death). 2. Upon separation from employment, there will be no charges or penalties assessed on withdrawals from your account. Your account is tax-deferred until you withdraw money after separation from employment. In general, a 457(b) plan may permit hardship distributions for unforeseeable emergencies if specific requirements are met. As a public employee you are required to complete and file this form within 45 days of beginning employment. Please fill out the form in blue or black ink. 2. Use this form if you want to: • request a distribution for a financial hardship due to an unforeseeable emergency. Your employer may permit you to take a loan from your deferred compensation plan.