If you want something cut, ONLY
If you want something cut out you will need to create or convert your file to a vector using vector software (Adobe Illustrator, Inkscape, etc). If your file is already in vector format add .001 stroke lines to all the areas you want cut.
If you already have an image file (JPEG, PNG, etc.) you will need to trace the image to get it into a vector format. Both Adobe Illustrator and Inkscape have bitmap tracing options. For information on bitmap tracing in Inkscape. There are also numerous online options available, however, your mileage may vary. Please note that bitmap tracing is not perfect and results depend on your image. Additional editing might be needed.
Anything that you want cut will need to have a stroke of .001 (depending on the software you use it might also be called hairline). Please note when you set your stroke line to .001 they will be difficult to see unless you zoom in closely.
Once you have prepared your file save/export it to a PDF and submit your file.
Example:
Stroke line around entire image
In this example all of the lines have a stroke of .001 meaning that everything in the image will be cut. Keep in mind not everything will turn out well being cut (e.g. text).
Result: