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FIS 0262 12-11 Name Address Change

FIS 0262 12-11 Name Address Change-2025

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The document outlines the procedure for appointing or canceling a Managing General Agent or Agency by an Insurance Company in Michigan. It includes sections for providing necessary details such as names, addresses, identification numbers, and the action requested (appointment or cancellation) along with the effective date. The form must be completed by the insurance company and submitted to the Department of Insurance and Financial Services, ensuring compliance with Michigan Insurance Code.

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