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Mi Uia 6347

This document is a request from the Michigan Unemployment Insurance Agency for Alton Marshall to provide identity verification documents. It informs him that he must report by June 09, 2020 to verify his identity or his unemployment benefits may be denied. It provides instructions on how to report in-person, by mail, or fax and lists acceptable identity document combinations from Lists A, B, and C that he must provide. It includes a certification statement and space for his signature and contact information to complete the identity verification process.

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Alton Marshall Sr.
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35K views1 page

Mi Uia 6347

This document is a request from the Michigan Unemployment Insurance Agency for Alton Marshall to provide identity verification documents. It informs him that he must report by June 09, 2020 to verify his identity or his unemployment benefits may be denied. It provides instructions on how to report in-person, by mail, or fax and lists acceptable identity document combinations from Lists A, B, and C that he must provide. It includes a certification statement and space for his signature and contact information to complete the identity verification process.

Uploaded by

Alton Marshall Sr.
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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e.

±3, STATE OF MICHIGAN


UIA 6347 Ag if Authorized By

-
(Rev. 01-18)
DEPARTMENT OF LABOR AND ECONOMIC OPPORTUNITY MCL 421.1 et seq.
\¥..~~,
,1 UNEMPLOYMENT INSURANCE AGENCY
Jeff Donofrio
Gretchen W hitmer
GOVERNOR
~ ti DIRECTOR

ALTON N MARSHALL
Mail Date: May 26, 2020
1153 HOYT ST SE
GRAND RAPIDS MI 49507-37 18 Letter ID: L0068599989
CLM: C77900780
Name: AlTON MARSHALL

Request for Information


Claimant Name: ALTON MARSHALL Benefit Year Begin: March 29, 2020
All individuals must establish their identity as part of the application process for unemployment benefits. Based on the
information you provided, we were unable to verify your identity. You must report to verify your identity by June
09, 2020. Failure to report or show good cause for why you failed to report by this date will result in a denial
of your unemployment benefits.

How to Report
You can report by mail, fax, or in-person. To report by mail or fax, return this completed form along with a copy of the
required documents to Unemployment Insurance Agency, PO Box 169, Grand Rapids MI 49501-0169 or fax to
1-517-636-0427. To report in person, visit your local Problem Resolution Office (PRO). To find the nearest PRO, go
to www.michigan.gov/uia under UIA Quick Links.

What to Provide
You must provide one document from List A below, or a combination of documents, one from List Band one from List
C. For a complete list of other acceptable documents, refer to the Employment Eligibility Verification Document (Form
1-9) at https://www.uscis.gov/i-9.

List A OR List B list C


AND
• US Passport or US Passport • Driver's license or ID Card • Social Security Card
Card • Original or certified copy of birth
• Permanent Resident Card Certificate
or Alien Registration Receipt
Card

If your name does not match these documents, you will need to provide proof of name change. Accepted documents
for this include, but are not limited to a marriage license or divorce decree.

Certification: I certify that the information I have reported is true and correct. I understand that if I intentionally make
a false statement, misrepresent facts or conceal material information to obtain benefits, I may be required to repay
benefits, charged penalties and could be subject to criminal prosecution.

Did you file this claim for unemployment benefits? □ YES □ NO

Signature Date Telephone Number

Print Name

•
UIA is an Equal Opportunity Employer/Program.
Auxiliary aids, services and other reasonable
111111111111 11111 IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIIII Ill llll accommodations are available upon request to
individuals with disabilities.

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