Form Cig 27 - Bond To Secure Purchases Of Stamps And Meter Impressions On Credit

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CIG 27
Rev. 4/04
Bond Number
P.O. Box 530
Columbus, OH
43216-0530
Bond to Secure Purchases of
Stamps and Meter Impressions on Credit
Know all men by these presents, that
located at
, city of
, county of
,
and state of
, as principal, and
of
authorized to do business in the state of Ohio, as surety, or sureties, are held and fi rmly
bound unto the state of Ohio in the sum of
dollars ($
),
for the payment of which, well and truly to be made, the principal and surety or sureties bind themselves, their heirs, execu-
tors, administrators, assigns and successors fi rmly by these presents in conformity with the provisions of Ohio Revised Code
(R.C.) section 5743.05.
Whereas, in accordance with the provisions of R.C. section 5743.05 and Rule 5703-15-04 of the tax commissioner, the
principal herein desires to obtain authorization from the tax commissioner to purchase cigarette tax stamps and/or meter
impressions from the Ohio Treasurer of State on credit:
Now, therefore, the condition of this obligation is such that if the principal, the said
, shall
within 30 days from the dates cigarette tax stamps and/or meter impressions are purchased, pay to the Ohio Treasurer of
State the total amount of tax represented by said stamps and/or impressions less any discount that may be authorized by
the tax commissioner for affi xing such stamps and/or impressions, then this obligation shall be null and void: otherwise, to
remain in continuous effect:
It is further agreed:
That, if the principal does not pay within 30 days from the date of purchase of said cigarette tax stamps and/or meter
impressions, the surety herein will forthwith make payment of any liability as set forth above to the extent of the penal amount
specifi ed herein.
That, this obligation is absolute and unconditional in that the liability of the surety is not contingent upon pursuit of the
principal, or assets of the principal, or any remedy against said principal, its properties, securities or interests whatever:
That, said surety hereby waives all right of protest or contest in its own behalf, or on behalf of said principal for any reason
whatever:
That, the surety may at any time cancel this bond by fi ling a 60-day written notice thereof with both the tax commissioner
and the Ohio Treasurer of State, in which event the liability of the surety shall terminate upon the expiration of said 60-day
period, except as to such liability of the principal as may have accrued prior to the expiration of said period:
In witness whereof, we have set our hands and seals this
day of
20
.
(Witness as to principal, or corporate seal)
Principal
by
Name and title
Surety
(Witness as to surety if without seal)
by
Attorney-in-fact
Approved as to form and amount this
day of
20
.
by
Tax commissioner
This surety, or sureties, on the foregoing bond is (are) hereby approved this
day of
20
.
Certifi cate of compliance, fi nancial statement and
by
power of attorney must accompany this bond.
Treasurer of state

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