Instructions for filing combined Notice of Withdrawal and Withdrawal Request form. You are allowed unlimited teller-assisted cash withdrawals for no fee at Mastercard Member.Court Forms and Instructions. Completing the Forms. Authorization to withdraw funds from an inmate's account for the purchase of a publication does not constitute approval of the publication. Use the checkboxes in the "Records We Can Share" section of the form to select what we can share. Phoenix Office 800 W. Washington Street Phoenix, AZ 85007. • A signed and dated University of Phoenix SOI Authorization Form,. Request withdrawal of my application for a Pledged Asset Line. 4.