Form B-A-29 - Tax Bond For Tobacco Products Other Than Cigarettes printable pdf download

B-A-29

Tax Bond for Tobacco Products

G.S. 105-113.38

Other Than Cigarettes

Web

3-07

North Carolina Department of Revenue

BOND NO.

KNOW ALL MEN BY THESE PRESENTS, that _________________________________________________________________ , of

(PRINCIPAL Name)

_______________________________________________________ , ________________________________________________, as

(PRINCIPAL Street Address)

(City/State/Zip Code)

PRINCIPAL, and _______________________________________________________________ , having its principal place of business

(SURETY Company)

at ________________________________________________________________________________________ and duly authorized to

(SURETY Complete Address)

engage in business as a SURETY company in the State of North Carolina, as SURETY, are held and firmly bound unto the State of North

Carolina in the sum of, __________________________________________________ dollars, lawful money of the United States, for the

(Amount of Bond)

payment of which, well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly

and severally, firmly by these presents.

WITNESSETH

WHEREAS, the PRINCIPAL is a licensed wholesale dealer or retail dealer as defined by the provisions of the North Carolina “Tobacco

Products Tax Act,” as amended; and

WHEREAS, under the provisions of said Act, as amended, the Secretary of Revenue may permit such wholesale dealer or retail dealer to

pay the excise tax imposed in Part 3 of the Act, as amended, on or before the twentieth day of each succeeding month, provided a bond

satisfactory to the Secretary shall have been filed with the Secretary conditioned to secure payment for such tobacco products excise tax;

NOW THEREFORE, the conditions of this Bond are as follows:

If said PRINCIPAL shall pay for all tobacco products excise tax due under the conditions and limitations prescribed by Part 3 of the

Act, as amended, and the rules and regulations promulgated thereunder by the Secretary of Revenue, then this obligation shall be

null and void, otherwise to be and remain in full force and effect.

The term of this Bond begins on the ____________ day of ___________________________ , ________, and shall continue in force

(Month)

(Year)

until made null and void in the manner set forth in paragraph No. 1 immediately above, or cancelled in the manner set forth in paragraph

3 immediately below.

The obligation of the SURETY may be cancelled upon 30 days’ written notice by registered mail given by the above-named SURETY

to the State of North Carolina through its agent, the Secretary of Revenue, at the address below; but such cancellation shall be

prospective in operation only from the effective date thereof, and shall not operate to release any liability which shall accrue or attach

before the effective date of such cancellation, whether such liability shall be ascertained or discovered before or after the effective

date of such cancellation.

Signed, sealed and delivered this

day of

(Month)

(Year)

INDIVIDUAL PRINCIPAL:

(SEAL)

(Signature)

(Print Name)

AFFIX SEAL OF

PARTNERSHIP PRINCIPAL:

(Print Name of Partnership)

CORPORATION/LLC

BY:

(SEAL)

(Signature)

(Title)

(Print Name of Signer)

ATTEST:

CORPORATION/LLC PRINCIPAL:

(Print Name of Corporation/LLC)

BY:

(Signature)

(Title)

(Signature)

(Title)

(Print Name of Signer)

(Print Name)

SURETY:

(Print Name of Surety Company)

AFFIX SEAL OF

BY:

SURETY

as Attorney in Fact for

(Signature)

SURETY HERE

(Print Name)

COUNTERSIGNED:

(N.C. REGISTERED AGENT OF SURETY)

North Carolina Department of Revenue, Attention: Tobacco Products Unit, P.O. Box 871, Raleigh, NC 27602

Form B-A-29 - Tax Bond For Tobacco Products Other Than Cigarettes

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