<?xml version="1.0"?>
<!-- The xsi:noNamespaceSchemaLocation and xmlns:xsi attributes in the below header line are optional; they may be used for local validation, but are not required for file submission. -->
<IHERequestforUICGroup SchemaVersionMinor="1" SubmittingSystemVersion="1.0" CollectionName="IHERequestforUIC" SubmittingSystemVendor="My System Vendor" CollectionId="108" SchemaVersionMajor="Collection" SubmittingSystemName="My System" xsi:noNamespaceSchemaLocation="http://cepi.state.mi.us/msdsxml/IHERequestforUICCollection1.xsd" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
	<IHERequestforUIC>
		<SubmittingEntity>
			<SubmittingEntityTypeCode>B</SubmittingEntityTypeCode>
			<SubmittingEntityCode>04481</SubmittingEntityCode>
		</SubmittingEntity>
		<PersonalCore>
			<LastName>Buster</LastName>
			<FirstName>Bronco</FirstName>
			<MiddleName>Richard</MiddleName>
			<StudentSuffix>Jr</StudentSuffix>
			<DateOfBirth>1988-12-12</DateOfBirth>
			<Gender>M</Gender>
		</PersonalCore>
		<IHEEntityDemographics>
			<SchoolFacilityNumber>04481</SchoolFacilityNumber>
			<StudentIdNumber>000001840</StudentIdNumber>
		</IHEEntityDemographics>
	</IHERequestforUIC>
</IHERequestforUICGroup>
