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Michigan.gov/uia UIA 1025 Rev. 03-04 Authorized by MCL 421. 1 et seq. Employer Request For Address/Name Change Current Employer Name UIA Employer Account No. Federal Employer ID No. FEIN New Employer Name DBA E-Mail Address PLEASE DO NOT SUBMIT THIS FORM UNLESS THERE HAS BEEN A CHANGE IN NAME OR ADDRESS. Physical Location of the Business Mailing Address No Post Office boxes please..

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