Fillable Form 70xn - Nebraska Motor Fuels Tax Bond Rider (Page 2 of 2) in pdf

Instructions

Who Must File. Every licensee with a current

70, must file this form to

Nebraska Motor Fuels Tax Bond, Form

report any changes in the bond.

When and Where to File. This rider must be filed prior to the effective date of any change in an existing bond or

before the date specified by the Motor Fuels Division when the Division requests a change in an existing bond. The

rider must be mailed to the Motor Fuels Division, PO Box 98904, Lincoln, NE 68509-8904.

New Motor Fuels Tax Bond. This form can only be used to amend an existing bond. All new bonds must be filed on

Nebraska Motor Fuels Tax Bond, Form 70.

Changes on Permits and Licenses. This form cannot be used to change any motor fuels tax permit or

license information.

To correct, terminate, or reinstate a permit or license, send a letter to the Motor Fuels Division. A change in either

the ownership or form of ownership of any motor fuels tax permit or license requires cancellation of the old permit

or license and the issuance of a new one.

Specific Instructions

Line 1. Enter the Nebraska ID number that you hold. Do not enter your Social Security number.

Line 2. Enter your federal employer ID number if you hold one. If one has been applied for, enter “applied for.”

If you do not have a federal employer ID number and have not applied for one, enter your Social Security number.

Line 4. Check the appropriate box to show whether the current bond is a combined bond. If it is a combined bond,

you must complete Nebraska Schedule – Combined Motor Fuels Tax Bond Rider on this form.

Name and Address. Enter the names and addresses as currently shown on the bond. A new name or address must

be entered on line 9 with an explanation of the change.

Line 5. Check the appropriate boxes to indicate the motor fuel tax programs covered by the current bond prior to

any changes.

Line 6. Check the appropriate boxes to indicate the changes made in the existing bond. One rider can be used to

make multiple changes in a current bond.

A Form 70XN is not required when only making a change in the location or mailing address.

Line 7. Indicate the surety’s total liability under the bond after the changes take effect.

Line 8. Enter the date that the changes made by the rider take effect. The Motor Fuels Division must receive this

rider prior to the effective date of the changes.

Line 9. Give a detailed explanation of the changes being made in the existing bond. Specifically state what provisions

are being changed and the conditions that will be in effect after the changes are made.

For additional information, please contact your account representative at the Motor Fuels Division, PO Box 98904,

Lincoln, NE 68509-8904, or call 800-554-FUEL (800-554-3835), or 402-471-5730. The Division’s website at

revenue.ne.gov/fuels.

NEBRASKA SCHEDULE — Combined Motor Fuels Tax Bond Rider

Amount of Bond

Tax Program

As Issued

After Amendment

4 Total of lines 1 through 3. Enter here and on line 7 on page 1 of this form. . .

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Form 70xn - Nebraska Motor Fuels Tax Bond Rider Page 2