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Get FIS 0865 - State Of Michigan - Michigan

All FIS 0862 forms must be attached to the FIS 0865 Third Party Administrator Jurat Page for Annual Renewal. Submit a completed FIS 0850 Third Party Administrator Financial Statement with the completed FIS 0865 Third Party Administrator Jurat Page for Annual Renewal. PA 218 of 1984 as amended requires submission and verification by Third Party Administrators requesting a renewal of their Michigan Certificate of Authority. FIS 0865 1/15 Department.

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