Form Gas-1262 - Motor Fuels Application - North Carolina Department Of Revenue - 2008 Page 22
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GAS-1220
Motor Fuels Tax
Web-Fill
5-09
Irrevocable Letter of Credit
PRINT
CLEAR
North Carolina Department of Revenue
We, ___________________________________________________________________________________,
(Financial Institution)
being authorized to conduct business in the State of North Carolina, hereby establish our Irrevocable Letter of Credit
(No._______________________) in favor of the North Carolina Secretay of Revenue, and agree to pay to you any
liabilities, up to an aggregate amount of __________________________________________________________________
_______________________________Dollars ($_________________), hereafter found by you to be due from
__________________________________________________________________________________ under Subchapter V of
(Principal - Legal Entity)
Chapter 105 of the General Statutes, including but not limited to Articles 36B, 36C, or 36D, and the authority of
Chapter 119, including but not limited to Article 3, as the same may be from time to time amended, modified, recodified,
or otherwise rewritten, to the payment of which, well and truly to be made, we bind ourselves, our heirs, administrators,
successors and assigns firmly by these presents to be effective as to acts or omissions occuring on or after the
___________ day of _________________________, 20 _________, hereinafter referred to as the effective date.
Said payment shall be made upon written demand accompanied by a copy of the official notice of assessment
or other document upon which the taxpayer’s obligation to pay is based. We engage with you that any demand or
presentment made under and in compliance with the terms of this credit shall be duly honored by us, as specified,
covering acts or omissions occuring on or after the above-stated effective date and on or before the ___________day
of _________________________, 20________, hereinafter referred to as the expiration date, or any extended expiration
date of this Irrevocable Letter of Credit as set forth below.
It is a condition of this Irrevocable Letter of Credit that it shall be deemed automatically extended annually
without amendment, with approval of the Secretary of Revenue, for an additional period of one year from the above or
any extended expiration date unless we shall notify the Secretary by registered mail postmarked sixty (60) days prior
to such expiration date or from any future expiration date that we elect not to renew this Irrevocable Letter of Credit for
such additional period. Such annual election shall not relieve, release or discharge us from any obligations under this
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