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STATE OF MICHIGAN WORKERS COMPENSATION ALONG TERM DISABILITY CLAIM FORM Is this a Workers Compensation Claim Yes No Sends to:Citizens Management Inc. P.O. Box 740 Howell, Michigan 488440740 Phone:
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This is a form used by businesses to determine if an individual is considered an employee or an independent contractor for tax purposes.
Businesses are required to file this form.
The form should be filled out with accurate information about the individual's work relationship with the business.
The purpose of this form is to ensure that businesses are correctly classifying their workers for tax purposes.
Information such as the individual's name, address, Social Security number, and details about their work relationship with the business.
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