Enter your information and print out the completed form, or print clearly, preferably in capital letters and black ink. Mail the form to the address below.The forms can be filled in on the computer. Refer to the Supersede and Withdrawal Guide for instructions. By completing this form I am with- drawing from membership or my membership has ceased. If I am withdrawing an active membership, I certify that I have resigned. Send redemption proceeds: via ACH to my bank. Send a Dispute Letter to Your Card Company. Please read carefully and complete this checklist before filling out the Retroactive Withdrawal Request Form. Learn everything there is to know when it comes to opening and withdrawing from an estate account in NYC.