Form Ador 74-4023 - Taxpayer Bond For Contractor
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1TAXPAYER BOND FOR CONTRACTOR
TAXPAYER BOND FOR CONTRACTOR
UNDER ARS § 42-5006
UNDER ARS § 42-5006
Industry Classifi cation:
Bond No:
Transaction Privilege Tax License No:
Bond Amount:
with a
principal place of business at
, as
principal, and
a corporation,
authorized to transact surety business in the State of Arizona as surety, are held and are fi rmly bound unto the State of Arizona and the
Arizona Department of Revenue for the payment of the transaction privilege taxes imposed by this state or political subdivisions of this state
in the sum of
dollars ($
) in lawful money of the United States
of America for the payment of which we bind ourselves, our heirs, executors, and assigns jointly and severally.
The principal is a contractor who desires to engage in business in the State of Arizona and is required by law to execute a bond in compliance
with all provisions of ARS § 42-5006.
If the principal complies with all provisions of ARS Title 42, including, but not limited to, payment of all transaction privilege taxes, penalties,
and other obligations incurred by the principal and which are adjudged due and owing by the principal during the term of this bond, this
obligation is void; otherwise the obligation remains in full force and effect. After notice and a hearing pursuant to ARS Title 42, the Director of
the Arizona Department of Revenue may order forfeited to this State and any affected political subdivision any part or all of the surety bond
for nonpayment of those taxes, penalties or other obligations.
The term of this bond is continuous and regardless of the number of years it remains in force and effect, the liability of the surety shall not
exceed the amount stated in this bond. This bond is effective the
day of
, 20
, and shall continue
in force until terminated as provided in this bond. The surety may terminate this bond after two years from this date by written notice to the
Arizona Department of Revenue, 1600 W Monroe, Phoenix AZ 85007. Such termination shall become effective 30 days after the actual
receipt of the notice by the Department. Termination of the bond does not affect any rights or liabilities which have accrued under this bond
prior to the termination.
Signed and dated this
day of
. 20
.
Principal
By
Title
Address
Surety
Please Affi x Original
Please Affi x Original
Surety Bond
Surety Bond
By
Attorney
Corporate Seal Here
Corporate Seal Here
Address
Subscribed and sworn to before me this
day of
, 20
.
My commission expires:
Date
Notary Public
ADOR 74-4023 (3/05)
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