Cardholder Withdrawl Request

Name:
Date: (xx/xx/xx)
University ID Number (UNID):
University ISO Number:
Mailing Address:
City:
State:  ZIP:
Contact phone:
Contact email:
Withdrawal Amount:$ Express*

*Check processing time is 4-6 weeks. An express check can be processed for $12.00. Express checks are processed in 2-3 days.


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