For businesses operating within Michigan, maintaining accurate records with the State's Unemployment Insurance Agency (UIA) is crucial, especially when changes occur in their name or address. The UIA 1025 form, authorized by the Michigan Department of Labor & Economic Growth, is specifically designed for this purpose. This document facilitates the process for employers to inform the agency of any changes in their business name or address, ensuring that their account information remains current. It's essential for employers to submit this form when such modifications take place to guarantee seamless communication and compliance with state regulations. The form also outlines the necessity of including both the physical and mailing addresses of the business, highlighting the specific scenarios that may require the submission of additional documents, such as discontinuance, disposition of business, or changes in corporate structure. Additionally, it mentions the requirement for a Power of Attorney Authorization form if an employer representative's change of mailing address is requested, underlining the importance of proper authorization for such actions. By mandating a signature, title, and telephone number before any changes are accepted, the UIA 1025 form underscores the significance of accountability and proper verification in the update process. Employers are provided with contact information for further assistance, and the option to obtain forms via fax or the UIA website, facilitating easier access to necessary documentation.
| Question | Answer |
|---|---|
| Form Name | Michigan Form Uia 1025 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | E-Mail, MCL, DBA, gov |
|
|
|
|
|
State of Michigan |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
Department of Labor & Economic Growth |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
UIA 1025 |
|
|
UNEMPLOYMENT INSURANCE AGENCY |
|
|
|
|
|
|
|
|
|
|
|
|
|
Authorized by |
||||||
|
|
Tax Office |
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||
(Rev. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
MCL 421.1, et seq. |
|||||||
|
|
P.O Box 8068 • Royal Oak, Michigan |
|
|
|
|
|
|
|
|
|
|
|
||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
|
|
|
|
|
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: _________________________________________________________________________________________________ |
|||||||||||||||||||||
|
|
||||||||||||||||||||||
|
|
|
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: |
|
|
|
|
Street: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
City: |
|
|
|
|
City: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
State: |
|
Zip Code: |
– |
|
State: |
|
Zip Code: |
|
|
|
|
|
|
|
|
|
|
– |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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
Mail this form with your changes to the above address, or fax to (313)
FORMS MAY BE FAXED TO YOU 24 HOURS A DAY BY CALLING:
OUR WEBSITE: www.michigan.gov/uia.