Form Rt 133 - Motor Fuel Distributor Bond printable pdf download

Form Rt 133 - Motor Fuel Distributor Bond

STATE OF NEW HAMPSHIRE

DEPARTMENT OF SAFETY

ROAD TOLL BUREAU

33 HAZEN DRIVE, CONCORD NH 03305

TELEPHONE: (603)271-2311

MOTOR FUEL DISTRIBUTOR BOND FORM

KNOWN ALL MEN BY THESE PRESENTS, THAT WE (Motor Fuel Distributor):

COMPANY NAME:

ADDRESS 1:

ADDRESS 2:

CITY/TOWN:

STATE:

ZIP CODE:

AS PRINCIPAL, AND THE (Surety):

COMPANY NAME:

ADDRESS 1:

ADDRESS 2:

CITY/TOWN:

STATE:

ZIP CODE:

A CORPORATION DULY ORGANIZED UNDER THE LAWS OF THE STATE OF ___________ AND LICENSED TO DO BUSINESS IN THE

STATE OF NEW HAMPSHIRE AS SURETY, ARE HELD AND FIRMLY BOUND UNTO THE STATE OF NEW HAMPSHIRE, AS OBLIGEE, IN

THE SUM OF $__________________DOLLARS FOR THE PAYMENT OF WHICH, WELL AND TRULY TO BE MADE, WE JOINTLY AND

SEVERALLY, BIND OURSELVES. OUR HEIRS, EXECUTORS, ADMINISTRATORS, SUCCESSORS AND ASSIGNS BY THESE PRESENTS.

SIGNED, SEALED, AND DELIVERED THIS _____DAY OF ___________, ______.

WHEREAS, THE SAID PRINCIPAL HAS MADE APPLICATION TO THE ROAD TOLL BUREAU OF THE STATE OF NEW HAMPSHIRE FOR A

LICENSE TO ENGAGE IN THE BUSINESS AS A DISTRIBUTOR OF MOTOR FUELS, AS PROVIDED IN CHAPTER 260 NH REVISED

STATUTES ANNOTATED 1955 AS AMENDED.

NOW THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH THAT IF SAID PRINCIPAL AS SUCH LICENSEE SHALL PROMPTLY

FILE TRUE REPORTS AND MAKE PAYMENT OF ALL MOTOR VEHICLE ROAD TOLLS, TOGETHER WITH ALL PENALTIES AND INTEREST

THEREON, WHICH ARE IMPOSED UPON HIM BY THE PROVISIONS OF SAID CHAPTER 260, AND ANY AMENDMENTS THERETO, AT THE

TIMES AND IN THE MANNER THEREIN PROVIDED, AND SHALL FAITHFULLY COMPLY WITH ALL PROVISIONS OF SAID CHAPTER

RELATING TO HIM AS SUCH LICENSEE, DURING THE PERIOD THAT SAID PRINCIPAL SHALL BE LICENSED AS SUCH DISTRIBUTOR,

THEN THIS OBLIGATION SHALL BE VOID.

RT 133 (Revised 03/2010)

Form Rt 133 - Motor Fuel Distributor Bond