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EMPLOYER PAYMENT COUPON/REMITTANCE Michigan …

EMPLOYER PAYMENT COUPON/REMITTANCE Michigan

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DHS-1258 (Rev. 5-15) Previous edition obsolete. MS Word EMPLOYER PAYMENT COUPON/REMITTANCE Michigan Department of Health and Human Services Employer Name Date of Withholding Federal Employer Identification Number (FEIN)

  Department, Payments, Michigan, Employers, Remittance, Coupon, 5218, Employer payment coupon remittance michigan, Employer payment coupon remittance michigan department

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