Form Ap-111 - Texas Motor Fuels Tax Continuous Bond
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2AP-111
(Rev.3-06/7)
TEXAS MOTOR FUELS TAX CONTINUOUS BOND
• PLEASE READ INSTRUCTIONS
• TYPE OR PRINT
• DO NOT WRITE IN SHADED AREAS
1. Fuel type (Separate bonds must be submitted for each fuel type)
GASOLINE
DIESEL FUEL
2. Applicant name
3. Federal E.I. No. or Social Security No.
4. Mailing address (P.O. Box or Street No.)
City
State
ZIP code
County
SURETY/SECURITY INFORMATION
5. Legal name of surety company
6. Mailing address of surety company
City
State
ZIP code
County
7. Surety company Federal Employer’s Identification Number
8. Does surety company have a Taxpayer Number for reporting
If “YES,”
any Texas tax OR a Texas Vendor Identification Number?
YES
NO
enter number
9. Bond beginning effective date
Bond number
Bond amount
10. BOND CONDITIONS
KNOW ALL PERSONS BY THESE PRESENTS:
That the applicant as PRINCIPAL and the named bonding company as SURETY, duly authorized and qualified to do business as a surety
company in the State of Texas, are held and firmly bound to THE STATE OF TEXAS in the sum of $ __________________ payable at Austin,
Texas, and for the payment of which we bind ourselves, our heirs, executors, and assigns, jointly and severally.
This bond is conditioned upon the principal being issued or having applied for a license pursuant to the provision of TEX. TAX CODE ANN.
sec. _________________________ .
If PRINCIPAL complies with the provisions of the cited statute and pays to the State of Texas, through the Comptroller of Public Accounts,
at Austin, Texas, all taxes including penalty, interest, and costs accruing under the cited statute, this obligation shall be null and void. Otherwise,
it remains in full force and effect.
This bond shall be continuous in form from the effective date and shall be automatically extended from calendar year to calendar year. It
shall constitute a new and separate obligation, in the amount of the sum named herein, for each calendar year while the bond is in force.
This bond is not invalidated by recovery on this bond, the execution of any new bonds, or the renewal of a license. In addition, this bond
shall not be invalidated by the revocation, renewal or issuance of a license, but a new bond may be demanded if a new license is issued or
renewed. The State of Texas shall have the right to sue on and otherwise enforce the obligations of this bond without exhausting its remedies
against PRINCIPAL’s property or assets, and PRINCIPAL need not be made a party to such suit.
11. In witness whereof we have set our hands and seal this _______ day of ______________________ , _________ .
SEAL
SURETY
12.
Principal or authorized agent
Title
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