Form Sfn 59903 - Sales And Use Tax Permit Surety Bond
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1"For Offi ce Use Only"
SALES AND USE TAX PERMIT SURETY BOND
OFFICE OF STATE TAX COMMISSIONER
SFN 59903 (Rev. 5-2011)
Name of Principal
Address
City
State
Zip Code
Name of Surety Company
We, the above named, are held and fi rmly bound to the State of North Dakota in the penal sum of
_______________________ dollars ($_________________) for the payment of which we jointly and severally bind
ourselves, our heirs, administrators, executors, and assigns fi rmly by this obligation.
Signed this ___________ day of _____________________, _______.
We agree that as a condition of the issuance or reinstatement of the above-identifi ed sales and use tax permit, or
release of any corporate offi cer 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 fi led in the Offi ce of the State Tax Commissioner by the Principal. The Bond is conditioned to secure the prompt
fi ling 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 fi le 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
Address of Legal Residence
City
State
Zip Code
Signature of Authorized Agent for Surety Company
Address of Legal Residence
City
State
Zip Code
The original of this document must be returned to the Offi ce 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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