Form 0405-062 - Fisheries Business Tax Bond

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Alaska
062
Fisheries Business Tax Bond
Principal Name___________________________________ Bond Number____________________________
Principal Address _________________________________
_________________________________
Business Type (check one):
Corporation
Partnership
Sole Proprietor
LLC
Other__________________________
We, as principal(s), and ____________________________________________________________ as surety,
(Name of Insurance Company)
a corporation incorporated under the laws of the State of __________________________________________
(State of Incorporation of Surety)
authorized to do business in the State of Alaska, execute this bond and are held and firmly bound unto the State
of Alaska, Department of Revenue, in the sum of $____________________________ for the payment of which
(Amount of Bond)
we bind ourselves, our executors, administrators, heirs, assigns, and successors, jointly and severally, firmly by
this bond.
The condition of the foregoing obligation is that the above bound principal(s) shall pay when due all fisheries
assessments, fees and/or taxes, penalties and interest due and to become due and owing to the State of Alaska
by said principal for the calendar year _______________________________ under the provisions of the fish
tax, assessments and licensing laws of the State of Alaska.
This bond may not be cancelled and, furthermore, the liability herein assumed is to continue until the statute of
limitations has expired on all fisheries taxes due to the State of Alaska of the aforementioned principal for the
calendar year indicated above and incurred at
_______________________________________________________________________________________
(Physical Location of Fisheries Business Operation)
In witness whereof, the above bound parties have executed this instrument this ___________________day of
_____________________________, 20 _______ the name and seal of each party being hereto affixed and is
duly signed by its undersigned representative, if any, pursuant to authority of its governing body.
(seal)
__________________________________________
ATTEST:
(Principal)
______________________________
By: _______________________________________
(Secretary of Principal)
(Authorized Agent)
(seal)
__________________________________________
ATTEST:
(Surety)
______________________________
By: _______________________________________
(Secretary of Surety)
(Authorized Agent)
062
Mail to: Alaska Department of Revenue, PO Box 110420, Juneau AK 99811-0420
0405-062 Rev 12/18/13

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