Form Tc-763 - Surety Bond For Fuel Taxes 1999

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Utah State Tax Commission
TC-763
Surety Bond
Rev. 6/99
For Fuel Taxes
Owner/Partner or principal officer's name (Principal)
Bond number
Name of company, partnership, or corporation (DBA)
Street address, city, state, and ZIP code (Principal place of business)
Name of surety company
What state is surety company located?
The
Principal and Surety,
to guarantee payment of any and all fuel taxes, do
post
this bond for:
Bond amount for motor fuel
A bond is required in an amount twice the estimated monthly tax, with a
Motor Fuel License
$
minimum bond of $35,000, but not to exceed $100,000.
Bond amount for special fuel
Special Fuel Supplier
A bond is required in an amount twice the estimated monthly tax, with a
License
$
minimum bond of $35,000, but not to exceed $100,000.
A bond is required, UNLESS the monthly average tax liability is $500 or less and
Bond amount for aviation fuel
retail sales of aviation fuel are made to both federally certificated air carriers and other
Aviation Fuel License
$
persons. Otherwise, a bond IS required in the amount twice the monthly estimated
tax, with a minimum of $2,000, but not to exceed $100,000.
This bond binds ourselves, our heirs, executors, administrators, and successors both jointly and individually.
This bond is effective on _______________________________.
In accordance with Utah Code Title 59, Chapter 13, the
Principal
shall do the following:
1. File true and timely reports as required of suppliers and/or distributors of fuels as specified by law.
2. Pay to the Utah State Tax Commission all taxes specified by the fuel tax laws of Utah in the manner
set by the Utah State Tax Commission, including all applicable interest and penalties; and
3. Perform all the requirements of Utah law regarding the fuel tax laws and rules of the Utah State Tax Commission.
This agreement shall remain in full force and effect unless the license required to distribute or sell fuels in Utah is revoked. In which
case, this obligation shall remain in full force and effect with regard to all transactions of the Principal for thirty (30) days from the date
of revocation of the fuel permit.
Upon written request to the Utah State Tax Commission, the above-named Surety shall be released and discharged from any and
all liability to the State of Utah accruing from this bond after thirty (30) days of receipt of such written request. However, this request
shall not release or discharge the Surety from any liability already accrued, or which shall accrue, before the expiration of the
thirty (30) day period.
Location this instrument was executed by the Principal and Surety
Date
Name of Principal
Surety
Signed by
Signed by
Utah resident agent
(Surety Seal)
Attach this form and a copy of the bond(s) to the Fuel License
Application, form TC-107.

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