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Free Michigan Uia 1025 Template in PDF

The Michigan UIA 1025 form is a document used by employers to request a change in their business name or address with the Unemployment Insurance Agency. This form is essential for maintaining accurate records and ensuring that all correspondence is directed to the correct location. Employers should only submit the UIA 1025 when there has been a change in their business details.

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The Michigan UIA 1025 form serves a crucial role for employers who need to update their business information with the Unemployment Insurance Agency. This form is specifically designed for employers to request changes to their name or address, ensuring that the agency has accurate and current information. It is important to note that this form should only be submitted when there has been a change in name or address; unnecessary submissions may complicate the processing of valid requests. The form collects essential details such as the current and new employer names, the UIA employer account number, and the Federal Employer Identification Number (FEIN). Additionally, it requires the physical location and mailing address of the business, emphasizing that post office boxes are not acceptable for mailing addresses. Employers must also provide contact information, including an email address and telephone number, to facilitate communication. If there have been significant changes to the business structure, such as a merger or discontinuation of operations, employers are directed to use different forms, like the UIA 1772 for reporting business discontinuance. The UIA 1025 form must be signed and dated by the preparer, adding an extra layer of accountability. For those needing assistance, the form provides helpful contact information for further guidance.

Form Example

State of Michigan

Department of Labor & Economic Growth

UIA 1025

UNEMPLOYMENT INSURANCE AGENCY

Authorized by

Tax Office

(Rev. 03-04)

MCL 421.1, et seq.

P.O Box 8068 • Royal Oak, Michigan 48068-8068

www.michigan.gov/uia

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.

(Include both addresses, even if only one has changed.)

Street:

City:

State:

Zip Code:

–

State:

Zip Code:

–

E-Mail Address:

Mailing Address is:

Employer's Telephone Number: (

)

Accountant/Employer Rep*

Corporate Office

Owner

*To request a change of mailing address to an employer representative (CPA, Service Bureau, Attorney, etc.) YOU MUST FILE A POWER OF ATTORNEY AUTHORIZATION FORM.

CHANGING ACCOUNT INFORMATION: If you have discontinued or ceased business activity, discontinued employment, sold or transferred ownership of all or part of your business, formed a new partnership or corporation, merged, or changed your status as a sole proprietorship or corporation, you must file a Report of Discontinuance or Disposition of Business, Form UIA 1772.

To request Form UIA 1772, check here

or call the number(s) listed below.

THE CORRECTION OF A PREVIOUSLY FILED REPORT (UIA 1020) MUST BE MADE ON AN Amended Quarterly Tax Report, Form UIA 1021. Other changes, including FEIN changes or bankruptcy filing, etc., must be submitted in writing with supporting documentation. YOU MUST sign and date this form, giving your title and telephone number, before changes will be accepted.

Preparer: _______________________________________ Title: ___________________________________________

Date: ____________________ Preparer Telephone No.: ( ________ ) _________________________

If you need assistance, telephone 1-800-638-3994, outside Michigan 1-313-456-2180.

Mail this form with your changes to the above address, or fax to (313) 456-2130. If known, indicate your Tax Team ____.

FORMS MAY BE FAXED TO YOU 24 HOURS A DAY BY CALLING: 1-800-638-3994 FORMS CAN ALSO BE OBTAINED ON

OUR WEBSITE: www.michigan.gov/uia.

▼ Michigan Uia 1025 PDF Form

Document Specs

Fact Name	Details
Form Purpose	The UIA 1025 form is used by employers to request a change in their business name or address.
Governing Law	This form is authorized under Michigan Compiled Laws (MCL) 421.1, et seq.
Submission Requirement	Employers should only submit this form if there has been a change in name or address.
Mailing Instructions	Completed forms should be mailed to P.O. Box 8068, Royal Oak, Michigan 48068-8068.
Contact Information	For assistance, employers can call 1-800-638-3994 or 1-313-456-2180 if outside Michigan.
Additional Forms	If business activity has ceased or ownership has changed, employers must file Form UIA 1772.
Correction Process	Corrections to a previously filed report must be made using Form UIA 1021.
Signature Requirement	The form must be signed and dated by the preparer before any changes will be accepted.

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