Form Sf-2 - Special Fuel License Bond
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1
2For Department Use Only
License Number
Permissive
Terminal
Eligible
Supplier
Supplier
Operator
Transporter
Exporter
Purchaser
Importer
Bond
Amount
Bond Number
Form SF-2
SF# 46841
Special Fuel License Bond
(R3 / 12-08)
Surety bond given by
of
Name of Principal
Street Address
City-Town of
Name of City or Town
County of
, and State of
, as principal, and
Name of County
Name of State
of
Name of Surety
Street Address
, as surety, to the State of Indiana in the sum of
City
State
Zip Code
Dollars, for the payment of which, we bind ourselves, our heirs,
executors, administrators and assigns.
The above principal,
, has applied for, and,
Name of Principal
subject to the execution of a bond as provided by law, has obtained a
License Type
license(s) to engage in a business as defi ned under Indiana Code 6-6-2.5 entitled “Special Fuel Tax Law”, and all acts
and regulations amendatory thereof and supplemental thereto, now in force or which may hereafter be enacted, imposing
certain duties, obligations and liabilities upon said principal, the provisions of which act and all acts amendatory thereof
and supplemental thereto being by reference made a part hereof.
If the above principal,
, shall pay all license
Name
fees, license taxes, penalties and interest and do, pay and perform all and singular the duties, obligations and liabilities
imposed upon him by virtue of the aforesaid acts in the manner and at the times provided therein, then this obligation is
void; otherwise it remains in full force and effect.
If the surety shall so elect, this bond may be cancelled by giving sixty (60) days’ written notice of such cancellation
to the principal and a like sixty (60) days’ written notice to the Indiana Department of Revenue, hereinafter referred to as
the Department. Cancellation shall become effective at the expiration of sixty (60) days from the Department’s receipt of
written notice, as provided by law, unless a new bond is fi led by such principal and approved by the Department prior to
such time, in which event such cancellation shall be effective from the date of the approval of such new bond. Notice of
cancellation shall not affect the liability of the surety for any acts or omissions of the principal occurring prior to the date
when the cancellation shall become effective, but the surety shall continue to be liable under all of the provisions of this
bond for all acts and omissions of such principal occurring prior to the cancellation to the same extent as if such notice of
cancellation had not been given. The principal binds himself, his successors and assigns, upon receipt of such notice and
within said period of sixty (60) days, to prepare and fi le with the Department a new bond to the satisfaction and approval
of said Department, in the sum required by the Department with surety to be approved by said Department.
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