Form Rev-657 As - Bond License To Resell Amusement Tickets

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REV-657 AS (11-08)

BOND

LICENSE TO RESELL

AMUSEMENT TICKETS

PO BOX 280909

HARRISBURG, PA 17128-0909

Please Print or Type

Bond Number

TO BE COMPLETED BY SURETY COMPANY

KNOW ALL MEN BY THESE PRESENTS, THAT

Start

(Name of Principal/Licensee)

(Legal Name - dba)

(Post Office Box)

(Street and Number)

(City)

(County)

(State)

(ZIP Code)

as PRINCIPAL and

(Name of Surety)

a corporation organized under the laws of

duly authorized to engage in business in the Commonwealth of Pennsylvania and approved by the Pennsylvania Insurance Commission as to solvency

and responsibility for execution of this bond located at

in the City of

State of

as SURETY - are held and firmly bound unto

(Licensor)

(Post Office Box)

(Street and Number)

(City)

(County)

(State)

(ZIP Code)

LICENSOR, in the sum of $1,000 U.S. dollars, to be paid to said LICENSOR, to which payment well and truly to be made upon demand, we bind

ourselves and each of us, each of our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. This

bond to be effective as of

(Month)

(Day)

(Year)

WHEREAS, the above bound PRINCIPAL has made application to the LICENSOR for a “License to Resell Amusement Tickets” under the provisions

of Act 62 of May 2, 1947, as amended, to engage in the business of reselling amusement tickets in

(City or County)

said license to expire on Dec. 31, 20

WHEREAS, this bond is filed with the LICENSOR to enable said PRINCIPAL to obtain from the LICENSOR a “License to Resell Amusement Tickets.”

NOW, therefore, the condition of this obligation is such that if the above bound PRINCIPAL shall have obtained said license without fraud,

misrepresentation or misstatement made in the application for said license and shall faithfully comply with the provisions of Act 62 of May 2, 1947,

as amended, and the regulations of the Department of Revenue during the effective period of said license, then this obligation shall be void;

otherwise it shall be and remain in full force and virtue.

AND, in the event that the above bound PRINCIPAL shall have obtained said license by fraud, misrepresentation or misstatement made in the

application for said license or shall, from and after the effective date of the license aforesaid, fail in any respect to faithfully comply with the

provisions of Act 62 of May 2, 1947, as amended, we do hereby empower the Attorney General of the Commonwealth of Pennsylvania, or any

attorney of any court of record, to appear for and enter judgment against us or either of us, our or either of our heirs, executors, administrators,

successors or assigns for the above sum with costs of suit, release of all errors and without stay of execution. And we waive the right of inquisition

on any real estate which may be levied upon to collect the above sum, and we do hereby voluntarily condemn the same and authorize the

prothonotary to enter upon fieri facias our said voluntary condemnation. And we further agree that said real estate may be sold on fieri facias, and

hereby waive and release all relief from any and all appraisement, stay or exemption laws of any state. And for the entering of such judgment this

shall be the sufficient warrant for any such attorney, and a copy of this Bond being filed in said action, it shall not be necessary to file the original

as a warrant of attorney, any law or rule of court to the contrary notwithstanding.

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