Form Sfn 21886 - Sales And Use Tax Permit Bond
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1"For Office Use Only"
SALES AND USE TAX PERMIT BOND
_____________________________
OFFICE OF STATE TAX COMMISSIONER
SFN 21886 (Rev. 8-2002)
We, __________________________________________ of _____________________________________,
Print Name of Principal
Print Name of Business
as Principal, and ______________________________, as Surety, are held and firmly bound to the State of North
Print Name of Surety Company
Dakota in the penal sum of _______________________ dollars ($_________________) for the payment of which
we jointly and severally bind ourselves, our heirs, administrators, executors, and assigns firmly by this obligation.
Signed this ___________ day of _____________________, _______.
We agree that as a condition of the issuance or reinstatement of the above-identified sales and use tax permit, or
release of any corporate officer or LLC governor/manager from personal liability for the tax, penalty, and interest
that may become due on this permit of the principal, or upon demand by the Tax Commissioner, a Surety Bond must
be filed in the Office of the State Tax Commissioner by the Principal. The Bond is conditioned to secure the prompt
filing of true reports and the full payment of any and all sales and use tax, penalty and interest, that may hereafter
accrue and become payable under the sales and use tax laws of the State of North Dakota.
We further agree that if the Principal shall file all reports required by the sales and use tax laws and make full
payment of any and all sales and use taxes which may accrue and become payable to the State of North Dakota
under the provisions of the sales and use tax laws of the State of North Dakota, then this obligation shall be null and
void. Otherwise this obligation shall remain in full force and effect.
Principal: ______________________________________ ___________________________________________
Signature
Street, City, State, Zip code of Legal Residence
Surety Co.: _____________________________________ ___________________________________________
Signature of Authorized Agent
Street, City, State, Zip code of Legal Residence
The original of this document must be returned to the Office of State Tax Commissioner.
State of __________________________
County Of ________________________
On this ________ day of _________________________, ______, personally appeared before me the above
named __________________________________________ known to me to be the same person named in and
who executed the above obligation as Principal and acknowledged to me that he executed this obligation.
___________________________________________
Notary Public
____________________________________ County
State of ____________________________________
My Commission Expires_______________________
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