Template uia 1772 form

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Reset Form UIA 1772 (Rev. 6-11) STATE OF MICHIGAN LICENSING AND REGULATORY AFFAIRS UNEMPLOYMENT INSURANCE AGENCY Tax Office ­ Ste 11-500 3024 W Grand Blvd, Detroit, MI 48202 PHONE: 313-456-2180 FAX: 313-456-2131 www.michigan.gov/uia AUTHORIZED BY MCL 421.1 et.seq Discontinuance or Transfer of Payroll or Assets in Whole or Part NOTICE: Information furnished on this report is used to determine termination of...
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uia 1772