Form Otp-902 - Other Tobacco Products Distributor'S License Bond
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1
2Bond Number
Form OTP-902
State Form 50831
(R/ 02-02)
Other Tobacco Products Distributor’s License Bond
Surety bond given by
of
,
Name of Principal
Street Address
City-Town of
, County of
, and State of
Name of City or Town
Name of County
, as principal, and
of
Name of State
Zip Code
Name of Surety
, as surety, to the State
Street Address
City
State
Zip Code
of Indiana in the sum of
Thousand Dollars, for the payment of which, we bind ourselves, our heirs, executors,
administrators and assigns.
The above principal,
, has applied for, and subject to
Name of Principal
the execution of a bond as provided by law, has obtained an Other Tobacco Products Distributor’s License to engage in a business as
defined in Indiana Code 6-7-2-8 entitled “ Tobacco Products Tax Law,” and all acts and regulations amendatory thereof and supplemental
thereto, now in force or which may hereafter be enacted, imposing certain duties, obligations and liabilities upon said principal, the
provisions of which act and all amendatory thereof and supplemental thereto being by reference made a part hereof.
If the above principal,
, shall pay all license fees,
Name
license taxes, penalties and interest and does pay and perform all and singular the duties, obligations, and liabilities imposed upon him by
virtue of the aforesaid acts in the manner and at the times provided therein, then this obligation is void; otherwise it remains in full force
and effect.
If the surety shall so elect, this bond may be cancelled by giving sixty (60) days’ written notice of such cancellation to the
principal and a like sixty (60) days’ written notice to the Indiana Department of Revenue, Controller’s Division, hereinafter referred to as
the Division. Cancellation shall become effective at the expiration of sixty (60) days from the Division’s receipt of written notice, as
provided by law, unless a new bond is filed by such principal and approved by the Division prior to such time in which event such
cancellation shall be effective from the date of the approval of such new bond. Notice of cancellation shall not affect the liability of the
surety for any acts or omissions of the principal occurring prior to the date when the cancellation shall become effective, but the surety
shall continue to be liable under all of the provisions of this bond for all acts and omissions of such principal occuring prior to the such
cancellation to the same extent as if such notice of cancellation had not been given. The principal binds himself, his successors and
assigns, upon receipt of such notice and within said period of sixty (60) days, to prepare and file with the Division a new bond to the
satisfaction and approval of said Division, in the sum required by the Division with surety to be approved by said Division.
This bond may be cancelled by the principal, by filing a new bond with the Division, and giving written notice of such cancellation
to the Surety. Such cancellation shall be effective when the replacement bond is received by the Division; but shall not affect the liability
of the surety for any acts or omissions of the principal occurring prior to the date when such cancellation shall become effective. The
surety shall continue to be liable under all of the provisions of this bond for all acts or omissions of the principal occurring prior to the time
the cancellation shall become effective, to the same extent as if no notice of cancellation shall have been given.
Any show of leniency by the Division toward said principal in the enforcement of any of the provisions of the Tobacco Products
Tax Law or the making of any special arrangements between the Division and the principal herein with regard to any delinquency in the
payment of any amounts due for which such surety is liable as such under the provisions hereof, shall not in any manner release said surety
hereunder or reduce or affect its liability, but such liability as surety shall continue as fully and to the same extent and effect as if such
leniency had not been shown and such arrangements had not been made.
This bond is a continuing bond and shall continue in full force and effect from its effective date,
20
, until cancelled by agreement of the parties in the manner herein set out, or the filing of a new bond as required by the Tobacco
Products Tax Law.
IN WITNESS WHEREOF we have hereunto set our hand and seals this
day of
,
20
.
Principal
Attest:
By
Owner or President
Secretary of Corporation
Surety
By
Attorney in Fact
STATE OF
SS:
COUNTY
Before me, the undersigned, a Notary Public within and for the County and State aforesaid, this
day of
, 20
, personally appeared
(Owner or President)
and acknowledged the execution of the foregoing bond.
Witness my hand and seal this date.
Notary Public
My commission expires
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