en-USMichigan Department of Treasuryen-US3762 (Rev. 12-18)en-USen-USIssued under authority of Public Act 327 of 1993 and Public Act 244 of 1999. Filing is mandatory.en-USen-US1. NPM Nameen-US2. Account Number (FEIN, TR or ME Number)en-US3. Address (Street, City, State, ZIP Code)en-US4. Contact Personen-US5. Telephone Numberen-US6. Fax Numberen-US7. E-mail Addressen-USen-USQuarteren-USen-USen-USen-USJanuary 1 - March 31, 2019en-USApril 30, 2019en-USMay 15, 2019en-US1en-USApril 1 - June 30, 2019en-USJuly 31, 2019en-USAugust 15, 2019en-US2en-USJuly 1 - September 30, 2019en-USOctober 31, 2019en-USNovember 15, 2019en-US3en-USOctober 1 - December 31, 2019en-USJanuary 31, 2020en-USFebruary 15, 2020en-US4en-USen-USI hereby certify that the NPM named in Section 1 is not a participant in the Master Settlement Agreement and that, in accordance with 1999 PA 244, MCL en-USen-USen-USen-USTitleen-USen-USDateen-USen-USen-USen-USen-USTitleen-USen-USDateen-USen-USMichigan Department of Treasury,en-USTobacco Tax Uniten-USP.O. Box 30791en-USLansing, MI 48909en-USen-US en-USen-USRevenue & Collections Divisionen-US525 W. Ottawaen-USP.O. Box 30754en-USLansing, MI 48909en-USFor questions, call 517-636-4630.en-USen-USen-US American LegalNet, Inc. www.FormsWorkFlow.com