Form Dts 22 - Surety Bond Affidavit And Acknowledgement Of Surety

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DTS 22 (10/10/2013)
A Driver Training School uses this form to verify to DMV that it has obtained proper bond.
Complete this form and have it notarized. Return or mail the notarized form to the DMV Commercial
Licensing Division at the above address. The completed form may be faxed to (804) 367-2019.
Whereas we, __________________________________________________________________________________________________
doing business at _______________________________________________________________________________________________
as Principal and ________________________________________________________________________________________________
(Surety) a corporation of the state of ___________________________, duly authorized to do business within the Commonwealth of
Virginia, as Surety, are held and firmly bound unto the people of the Commonwealth of Virginia to indemnify any person who may be
aggrieved by fraud, fraudulent representation or violation by said Principal or his agents or employees acting for such Principal or within
the scope of the employment of any of the provisions of Chapter 17, Title 46.2 of the Code of Virginia, in the amount of Five Thousand
Dollars ($5,000) for Class B Driver Training Schools or One Hundred Thousand Dollars ($100,000) for Class A driver training schools, of
lawful money of the United States of America, for which payment, well and truly to be made, we bind ourselves, jointly and severally, our
joint and several heirs, executors, administrators, successors and assigns, firmly by these presents; provided, that the aggregate liability
under this bond shall not exceed
(check one:)
Five Thousand Dollars ($5,000) per year
(For Class B Driver Training Schools)
One Hundred Thousand Dollars ($100,000) per year
(For Class A Driver Training Schools)
WHEREAS, the above bounden Principal desires that a driver training school license be issued and thereafter reissued from time to
time by the Commissioner of the Department of Motor Vehicles, Commonwealth of Virginia; and
WHEREAS, this bond executed by the said Principal and Surety is filed with the Commissioner in compliance with the provisions of
Chapter 17, Title 46.2 of the Code of Virginia, to enable said Principal to obtain a license from the Department of Motor Vehicles under the
provisions of that law.
NOW THEREFORE, the conditions of this obligation are such that if the Principal shall well and truly observe and strictly and faithfully
comply with the aforesaid requirements of law, and shall save and keep harmless any person from any fraud practiced on him or fraudulent
representation made to him by such Principal or one of such Principal's agents or employees acting for the Principal or within the scope of
the employment, or from any loss or damage suffered by reason of the violation by such Principal or any such agent or employee of the
Provisions of Chapter 17, Title 46.2 of the Code of Virginia or of the driving training school regulations, then this obligation shall be null and
void; otherwise it shall remain in full force and effect.
This bond shall not automatically expire with the license for which it is initially issued, but shall continue indefinitely, from license renewal to
license renewal, as a new and separate obligation for each such license year. Surety may cancel this bond at any time upon thirty days
(30) prior written notice to the Commissioner, provided, however, such cancellation shall not operate to relieve, release or discharge the
Surety from any liability already accrued or which shall accrue before the expiration of the thirty day (30) period.
Signed and sealed this _____________ day of ___________________________________ , 20_____ .
_______________________________________ (SEAL)
Name of Principal (School)
_______________________________________ (SEAL)
Signature of Owner, Partner or Officer of the Principal
by: _______________________________________ (SEAL)
(Signature at right must be witnessed)
Name of Surety Company
_______________________________________ (SEAL)
Officer or Attorney in Fact for Surety Company
School License Number
_______________________________________ (SEAL)
Registered Virginia Agent
Bond Number


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