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Return the completed sheet to:
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James Fackler, facklerj@michigan.gov; (517) 636-0949
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Secretary of State Scheduling Request
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Directions: When completing the Excel SpreadSheet, start at Applicant's Name column and tab right to each column inputing necessary information. Please check the accuracy of your information. Review the footnotes below describing what information to include in each cell. Submit the Excel SpreadSheet electronically. Do not book twice as SOS may cancel both bookings!
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Number of RequestsApplicant Name (full legal name)Applicant's phone number (1)
Applicant's email address (2)
What product are you requesting? (3)Agency requesting appointment (4)Branch location requested
for appointment		AM (9-11) or PM (3-5)
appointment preference
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example: John James Smith(517) 555-1212JJSmith@gmail.comoriginal ID cardHOPE Hospitality & Warming CenterpontiacAM
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(1) Must be a reliable phone number - agency staff person supporting the client is acceptable
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(2) Must be a reliable email address - agency staff person supporting the client is acceptable
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(3) Original, Renewal, or Replacment Driver License, or Personal Identification Card
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(4) Name of the agency submitting this form
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