Fillable Form Dr 0219 - Cigarette License Surety Bond printable pdf download

Form Dr 0219 - Cigarette License Surety Bond

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DR 0219 (08/22/13)

*130219==19999*

COLORADO DEPARTMENT OF REVENUE

Excise Tax Accounting Section, Room 237

PO Box 17087

Denver CO 80217-0087

Cigarette License Surety Bond

Principal Name(s) (attach additional sheet(s) if necessary)

Doing business under the name

Principal place of business

We, as principal(s), and ______________________________________________________, as surety, a corporation

incorporated under the laws of the State of _______________________ and authorized to do business in the State of

Colorado, execute this bond and are held and firmly bound unto the State of Colorado, Department of Revenue, in the sum

of $___________________________________, the payment of which we bind ourselves, our executors, administrators,

heirs, assigns, and successors, jointly and severally, firmly by this bond. The total bond must be equal to the wholesaler’s

anticipated total monthly purchase of stamps pursuant to section 39-28-104. A wholesaler may file a replacement surety

bond if the wholesaler’s anticipated total monthly purchase of stamps changes after the wholesaler has been issued a

cigarette tax license.

The condition of this obligation is such that:

Whereas, the principal has made application to the Executive Director of Revenue of the State of Colorado for a

license to act as a wholesaler of cigarettes in the State of Colorado;

Now, therefore if the principal shall pay all taxes, penalties, and interest due or to become due under the law of

Colorado relating to cigarettes, and particularly under C.R.S. 39-28-101 , et. seq.

Notice from the obligee to the surety of default of any obligation herein upon the principal is expressly waived by

the surety.

This obligation shall be a continuing obligation until and unless sixty (60) days’ written notice of termination shall

be given to the Executive Director of Revenue or his or her successor.

Provided further, that any action upon this obligation may be instituted upon the behalf of the People of the State

of Colorado by the then Executive Director of Revenue or by his or her successor, and by service upon the surety. The

surety hereby waives any objection it may now or hereafter have concerning the capacity of the Executive Director

of Revenue or his successor to bring suit upon this obligation or to any rights said surety may have to require service

upon the principal.

In witness whereof, the principal(s) and the surety have hereunto set their hands and seals this

__________________ day of _______________________________. 20____.

(Corporate Seal of Principal)

Principal

Authorized Agent

Attest: Secretary

Attest: Surety

Form Dr 0219 - Cigarette License Surety Bond

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