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Get MI UIA 1925 2014

Ww.michigan.gov/uia REQUEST FOR NAME AND/OR ADDRESS CHANGE Reset Form Social Security Number: ________________________ Complete using black or blue ink – Do not use pencil. • CHECK APPROPRIATE BOX: Name Change Address Change NAME CHANGE *FOR A NAME CHANGE, SUBMIT A COPY OF LEGAL PROOF THAT DOCUMENTS THE CHANGE *After you filed your claim for unemployment benefits, you reported your name had changed since you last claimed benefits. Your claim has been processed under your form.

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