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The purpose of this withdrawal is for the following financial hardship:

1. To purchase my principal residence (excluding mortgage payments)

2. To pay unreimbursed tuition and related educational expenses for the next 12 months of post-secondary education for myself, my spouse, or any of my dependents

3. To pay unreimbursed expenses for medical care for me, my spouse, or any of my dependents, more specifically described as follows ...

4. To make payments necessary to prevent eviction from my principal residence or foreclosure on the mortgage of my principal residence

5. To pay funeral and/or burial expenses of my deceased parent, spouse, child or dependent

6. To repair damage to my principal residence due to a casualty (e.g., fire, storm, disaster declared by the federal government) that would qualify for a casualty deduction under Section 165 of the Internal Revenue Code, determined without regard to whether the loss exceeds 10% of adjusted gross income

The purpose of a non-safe harbor withdrawal is as follows;

1. To pay unreimbursed expenses for medical care for me, my spouse, or any of my dependent children of more than $1,000.00 or more incurred because of sickness or injury, which have not been reimbursed by benefits payable from Local 138, 138A, 138B, and 138C Welfare Fund.

2. To pay for expenses incurred for skilled nursing care for dependents and/or assisted living nursing home care.

3. To make payments necessary for tuition and/or room and board for 12 months to maintain my dependent child at a non-secondary educational institution or a school/institution for physically handicapped or emotionally disturbed children (or grandchildren claimed as dependent on a participant's tax return)