Form 72a071 - Motor Fuels Tax Refund Bond (City And Suburban Bus, Nonprofit Bus, Senior Citizen Transportation, Or Taxicabs)
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172A071 (10-06)
MOTOR FUELS TAX REFUND BOND
Surety Bond No. ____________
Commonwealth of Kentucky
DEPARTMENT OF REVENUE
Permit No. ________________
(City and Suburban Bus, Nonprofit Bus, Senior Citizen
Transportation, or Taxicabs)
KNOW ALL MEN BY THESE PRESENTS, that we, __________________________________________________, of
Name of Principal
____________________________________________ , County _________________________ , State of __________________,
Street Number and Name
Name of City or Town
as principal, and ____________________________________________ of ____________________________________________,
Name of Surety
Street Number and Name
_______________________________ , County __________________ , State of ________________ , ZIP Code ____________,
Name of City or Town
as surety, are held and firmly bound unto the Commonwealth of Kentucky in the sum of ________________________________
dollars, for the prompt and faithful compliance with the provisions of Kentucky Revised Statute 138.446, we bind ourselves, our
heirs, executors, administrators, successors and assigned jointly and severally, firmly by these presents.
The condition of this obligation is such that, whereas, the principal is now engaged in, or is about to engage in, the
operation of city and suburban buses, nonprofit buses, senior citizen transportation or taxicabs for the transportation of persons,
and in such operation is entitled to a refund of seven-ninths (7/9) of the tax paid on motor fuel used exclusively in regularly
scheduled operations, and whereas, the principal from time to time will be making applications to the Commonwealth of Kentucky
for refund of taxes paid on motor fuel;
NOW THEREFORE, the condition of this obligation is such that, if the above-bonded ______________________________
Name of Principal
shall faithfully comply with the provisions of the aforementioned act and repay to the Commonwealth of Kentucky any refunds
to which it is not entitled, then this obligation shall be void, otherwise it shall remain in full force and effect. Provided, however,
this bond can be terminated by the surety upon written notice to the department and principal given by registered mail 60 days in
advance.
IN WITNESS WHEREOF, we have hereunto set our hands this ______________________ day of ___________ , 20_____.
___________________________________________________
________________________________________
Name of Principal
Name of Surety Company
By ________________________________________________
By ______________________________________
Owner or President
___________________________________________________
________________________________________
Secretary
Kentucky Resident Agent of Surety Company
Approval ___________________________________ , 20 ____ .
By ______________________________________
Supervisor, Motor Fuels Tax Compliance Section
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Form 72a073 - Application For Approval To Receive A Refund Of Tax On Motor Fuels Consumed By City And Suburban Buses, Nonprofit Buses, Senior Citizen Transportation, And Taxicabs
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