Fillable Form 847c - Alaska Operator Surety Bond

Form 847c - Alaska Operator Surety Bond - 2013

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2013 Alaska Operator Surety Bond

847C

AS 05.15.122(b)(5)

Bond Number:

In order that

, (Operator) may obtain or renew a Games of Chance and Skill Operator License for the

State of Alaska,

, (Surety), agrees to be obligated, as surety, to the State of Alaska, for the sum of

thousand dollars ($____________________),

as the bond as required by AS 05.15.122.

The Above obligations shall remain in effect until the Operator pays all fees, interest and penalties due the State of Alaska as required under AS 05.15, and

all net proceeds, including interest due the authorizing permittee by the Operator under the various tax, licensing, and gaming laws of the State of Alaska.

The above obligations commence upon issuance of the Operator License and will then continue for two years after the expiration of the license. Liabilities

that arise during the period to which the bond applies shall be covered under this bond.

__________________________,

IN WITNESS WHEREOF, the surety has affixed its hand and seal this ____________________ day of

Select

_____.

Select

PRINCIPAL (Applicant)

SURETY

Name:

Signature:

Address:

Title: