Form Dos 1536-A - Bond - New York Department Of State (Page 2 of 2) in pdf

Bond

BUSINESS / INDIVIDUAL ACKNOWLEDGMENT

State of New York

)

) ss.:

County of

)

On this _________ day of ______________, (year) ________, before me, personally appeared

(applicants name)

to me known, who, being by me duly sworn, did depose and say that s/he resides in

;

(address)

that s/he is the

of the

;

(principal title, if applicable)

(name of business entity, if applicable)

the entity described in and which executed the instrument and s/he acknowledged to me that s/he executed the same for

the purposes therein mentioned or that s/he knows the seal of said entity; that the seal affixed to said instrument is such

entity seal; that it was so affixed by the order of the Board of Directors of said corporation; and that he signed his name

thereto by like order.

Notary Public

County

ACKNOWLEDGMENT BY CORPORATION (SURETY)

State of New York

)

) ss.:

County of

)

On this ___________ day of ____________________________, (year) _____________, before me, personally came

______________________________________________to me known, who, being by me duly sworn, did depose and say

that s/he resides in __________________________________________________________________________________;

that s/he is the _______________________________________ of the _________________________________________;

the corporation described in and which executed the within instrument; that s/he knows the seal of said corporation; that

the seal affixed to said instrument is such corporate seal; that it was so affixed by the order of the Board of Directors of

said corporation; and that s/he signed his/her name thereto by like order; and s/he further says that s/he is

acquainted with

and knows him to be the ___________________________________ of said corporation, that the signature of the said

corporation, that the signature of the said ____________________________________ subscribed to the within instrument

is in the genuine handwriting of the said _________________________________ and was subscribed thereto by like

order of the Board of Directors in the presence of him, the said

Notary Public

County

INSTRUCTIONS

The provisions of the General Business Law governing the licensing of the business given on the face of this bond are such that

before a license can be issued the approved surety bond must be on file in the Department of State.

The bond must be written, executed, acknowledged and approved before a filing can be accepted and must also bear a date with

the effective date of the license when issued. To accomplish this, applicants would arrange with the surety company to have the

contract of guaranty written on a conditional basis, so that it can be updated to become effective on the date of issuance of the license

applied for.

DOS 1536-a (Rev. 12/14)

Page 2 of 2

Form Dos 1536-A - Bond - New York Department Of State Page 2

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