Form B-C-790c - Change Of Name Liability Bond Rider

ADVERTISEMENT

Change of Name Liability Bond Rider
B-C-790C
Web
North Carolina Department of Revenue
3-07
NORTH CAROLINA
WAKE COUNTY
To be attached to and form part of Bond No._____________________dated ______________
(Date of Orignal Bond)
that ________________________________________________________, as SURETY, being
(SURETY Company)
made on behalf of _______________________________________________________, the
(PRINCIPAL Name)
PRINCIPAL therein, in favor of the STATE OF NORTH CAROLINA.
It is understood and agreed that the name of the PRINCIPAL is hereby changed to read:
___________________________________________________________________________
Nothing herein contained shall serve to waive, alter, modify or terminate any of the terms and
conditions of the subject Bond other than as herein expressly set forth.
This rider shall become effective as of the ______ day of _____________________, _______.
(Month)
(Year)
,
.
Signed, sealed and delivered this
day of
(Month)
(Year)
INDIVIDUAL PRINCIPAL:
(SEAL)
(Signature)
AFFIX SEAL OF
(Print Name)
CORPORATION/LLC
PARTNERSHIP PRINCIPAL:
(Print Name of Partnership)
BY:
(SEAL)
(Signature)
(Title)
ATTEST:
(Print Name of Signer)
CORPORATION/LLC PRINCIPAL:
(Print Name of Corporation/LLC)
(Signature)
(Title)
BY:
(Signature)
(Title)
(Print Name of Signer)
(Print Name)
SURETY:
(Print Name of Surety Company)
AFFIX SEAL OF
BY:
SURETY
as Attorney in Fact for
SURETY HERE
(Signature)
(Print Name)
COUNTERSIGNED:
(N.C. REGISTERED AGENT OF SURETY)
North Carolina Department of Revenue, P.O. Box 25000, Raleigh, NC 27640-0110

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 2