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UIA 1471-T Rev.6-11 State of Michigan Authorized by MCL 421. 1 et seq. Licensing And Regulatory Affairs UNEMPLOYMENT INSURANCE AGENCY Tax Office P. O. Box 8068 Royal Oak Michigan 48068-8068 PHONE 1-313-456-2180 FAX 1-313-456-2131 www. michigan.gov/uia Print Form Reset Form PROTEST OF A RE DETERMINATION Employer UIA Employer Account Number Street Address City State Zip Code I WISH TO PROTEST THE DETERMINATION MAILED ON I WISH TO APPEAL THE REDETE.

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