Michigan Notice of Change of Firm Affiliation

State:
Michigan
Control #:
MI-BKR-611E
Format:
PDF
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Description

Notice of Change of Firm Affiliation

A Michigan Notice of Change of Firm Affiliation is a document required by the Michigan Department of Insurance and Financial Services when a firm changes its affiliation. It must be filed within 30 days of the affiliation change and must be signed by both the existing and the new firm’s representative. There are three types of Michigan Notice of Change of Firm Affiliation: 1. Notice of Change of Firm Affiliation for a New Producer: This document is required when a new producer joins an existing firm. 2. Notice of Change of Firm Affiliation for an Existing Producer: This document is required when an existing producer changes firms. 3. Notice of Change of Firm Affiliation for a Firm Merger or Acquisition: This document is required when two firms merge or one firm acquires another.

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FAQ

Employer Self Service (ESS) for the Unemployment account only. Online through the Agency Website. Call: 410-260-7980 or 1-800-638-2937 Provide: Name, telephone number, Federal Employer Identification Number (FEIN), Central Registration Number (CRN), reason for closing account, and closing date.

How do I file a Motion? You file a motion by completing the form and filing it with the same court that signed the default entry or default judgment. There is a $20 motion fee for filing a motion to set aside default.

If using this form, sign and mail to: Michigan Department of Treasury, Registration Section, PO Box 30778, Lansing MI 48909.

File Form 5156, Request for Tax Clearance Application if you: Want to know your current total tax liability with the Michigan Department of Treasury.

A request to cancel your account must be made, in writing, within 15 days from the date of discontinuance. Form 4460, IFTA Request for Cancellation of Account is available on our website.

You can also submit any late or partial payments by check or money order to Michigan Department of Treasury, P.O. Box 30774, Lansing MI 48929.

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Michigan Notice of Change of Firm Affiliation