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Get MD DLLR/DUI 15 & DLLR/DUI 16 2012

S true and correct to the best of the signer’s knowledge $ ,$ $ $ ,$ $ $ . ¢ ¢ Photocopy both sides of this Report for your records • Mail this original (NO Photocopies) and your check to: Division of Unemployment Insurance, PO Box 17291, Baltimore, Maryland 21297-0365. State of Maryland • Department of Labor, Licensing and Regulation • Division of Unemployment Insurance Telephones: Baltimore Metropolitan Area: (410) 767-2412 Toll Free within Maryland: 1-800-492-5524 Internet Address.

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