Form Smf-6 - New Jersey Supplier Of Motor Fuels Tax Bond
Download a blank fillable Form Smf-6 - New Jersey Supplier Of Motor Fuels Tax Bond in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Smf-6 - New Jersey Supplier Of Motor Fuels Tax Bond with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1Division Use Only — DLN Stamp
Division Use Only — Date Stamp
Surety Instrument N
o
Division of Taxation
Send to:
PO Box 189
Pursuant to NJSA 54:39-101 et seq
Trenton, NJ 08695-0189
3-2011
Tax Bond
New Jersey Supplier of Motor Fuels
Form SMF-6
Principal
Name
Type of Business Entity
DBA
Contact
Phone:
Tax ID N
o
Email
Mailing
Business
Address
Address
Corporate Agent to the Principal
Surety
Name
Name
Address
Address
Email
Phone:
Email
Phone:
Surety Instrument
Amount
Issue Date
Period Covered
From:
To:
if no end date is specified, check here
The Surety is held and firmly bound to the State of New Jersey in the aggregate sum of this bond, to be paid to the State of New Jersey by the Surety or its successors, executors, administrators and assigns, both
jointly and severally. The condition of this obligation is such that, if the above bounden faithfully performs and discharges all the requirements and duties imposed under the Motor Fuel Tax Act, NJSA §54:39-
101 et seq, including payment of all taxes, penalties, interest, and any other obligation, then this obligation is to be void; otherwise to remain in full force and effect.
Signature of Principal
Signature of Surety
Primary
Primary Signature*
Primary Signature †
Printed Name
Printed Name
Primary Signatory’s Title
Date Signed
Primary Signatory’s Title
Date Signed
Witness
Witness’ Signature*
Witness’ Signature †
Printed Name
Printed Name
Witness’ Title
Date Signed
Witness’s Title
Date Signed
*By signing, the principal authorizes the State of New Jersey to make available to the Surety all
† By signing, the Surety agrees to accept the documents, schedules, and returns from the State of
documents, schedules, returns, or any other information related to this bond.
New Jersey as sufficient evidence of liability for this bond.
Acknowledgement
State of
)
Date of Acknowledgement
) SS
County of
)
The principal or authorized representative of the principal named personally appeared before me on the date of this acknowledgement to affirm and verify that he/she is authorized to execute the forgoing
instrument and acknowledged to me that he/she executed this instrument as and for the act and deed of the principal.
Notary Seal
Signature of Notary
Printed Name
Expiration of Commission
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial