Form Mf-134 - Cash Bond Form Page 2

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Any show of leniency by the Indiana Department of Revenue or those acting in its behalf toward the
Principal - Surety in the enforcement of Indiana Code 6-6-1.1 et.seq and 6-6-2.5 et.seq. or Indiana Code
6-8.1 et. seq. with regard to any delinquency in payment due for which this instrument indemnifi es shall
not reduce or release the obligations incurred by this instrument in any manner. Rather, this instrument
shall continue in full force and effect as if such leniency had not been shown or if such arrangements had
not been made.
IN WITNESS WHEREOF, we have hereunto set our hand and seal this
day of
, 20
.
Principal - Surety
By
Owner or President
Attest:
Secretary of Corporation
STATE OF
COUNTY
Before me, the undersigned, a Notary Public within and for the County and State aforesaid, this
day of
, 20
, personally appeared by
Owner or President
and acknowledged the execution of the foregoing bond.
Witness my hand and seal this date.
Notary Public
My commission expires
.

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