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NOTICE TO PRISONER: You are directed to complete the following form. INSPECTION REQUIRED: Advise Rural Development when work is complete.Approval Official: (DATE). This is called "revoking authorization. " You can use this sample letter . The Sit Coverdell ESA Withdrawal Authorization Form can be used to withdraw money from a Sit Coverdell Education Savings Account. Enter your court order number. A new, fully completed, authorization form must be submitted if you wish to have your child support payments withdrawn directly from your new account. A new, fully completed, authorization form must be submitted if you wish to have your child support payments withdrawn directly from your new account. To authorize electronic funds withdrawal from your bank account, you must complete and sign the EFT Authorization on PAGE 3 of FTB 3567.