Form 70 "Nebraska Motor Fuels Tax Bond" - Nebraska

What Is Form 70?

This is a legal form that was released by the Nebraska Department of Revenue - a government authority operating within Nebraska. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2020;
  • The latest edition provided by the Nebraska Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 70 by clicking the link below or browse more documents and templates provided by the Nebraska Department of Revenue.

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Download Form 70 "Nebraska Motor Fuels Tax Bond" - Nebraska

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Nebraska Motor Fuels Tax Bond
FORM
70
If combined bond, complete schedule on page 2.
1 Do you hold or have you previously held a
4 Total Amount of Bond
2 Federal Employer ID or
3 Surety Bond Number
Nebraska ID Number?
Social Security Number
c
c
Yes
No
If Yes, provide the number_________________________
Name and Legal Address Shown on Application
Principal’s Name and Mailing Address
Name
Name
Street or Other Mailing Address
Street Address
City
State
Zip Code
City
State
Zip Code
5
Effective Date of Bond
6 Indicate fuel tax licenses covered by this bond.
Minimum $20,000 bond for each license:
Minimum $10,000 bond for:
Minimum $1,000 bond for:
Month
Day
Year
Motor Fuels Tax
Producer
Aircraft Fuels Tax
Compressed Fuel Tax
Name and Mailing Address of Surety Company
Name and Mailing Address of Agent
Name
Name
Street or Other Mailing Address
Street or Other Mailing Address
City
State
Zip Code
City
State
Zip Code
Email Address
Phone Number
Email Address
Phone Number
Condition of Bond
The individual or firm, as principal, and the surety company, both duly qualified and
authorized to transact business in the State of Nebraska, are jointly and severally
liable to the State of Nebraska, in the bond amount shown above.
The principal has made application for, or holds licenses or permits as indicated in
this bond. If the principal pays all taxes, penalties, and interest due, or to become
due, under the laws of Nebraska relating to the motor fuels tax programs and
complies with all statutory and regulatory provisions, then this obligation will be
void; otherwise, it will remain in full force and effect. The obligation of this bond
begins on the effective date indicated above.
The bond will continue until the above-named surety company provides written
notification of cancellation to the Nebraska Department of Revenue. At least 30
days’ notice of cancellation must be provided. The bond will be cancelled at the end
of the last day of the calendar month following the month that written notice of
cancellation was received. This does not discharge the principal and surety from any
liability already due, or to become due, under the laws of Nebraska guaranteed by
this bond before the date of cancellation.
sign
here
Signature of Principal
Phone Number
Date
Signature of Attorney-in-Fact or Authorized Surety Company Officer
Phone Number
Date
Signature of Agent
Phone Number
Date
Mail this bond to: Nebraska Department of Revenue, PO Box 98904, Lincoln, NE 68509-8904.
3-183-1973 Rev. 9-2021
Page 1
Supersedes 3-183-1973 Rev. 7-2020
PRINT FORM
RESET FORM
Nebraska Motor Fuels Tax Bond
FORM
70
If combined bond, complete schedule on page 2.
1 Do you hold or have you previously held a
4 Total Amount of Bond
2 Federal Employer ID or
3 Surety Bond Number
Nebraska ID Number?
Social Security Number
c
c
Yes
No
If Yes, provide the number_________________________
Name and Legal Address Shown on Application
Principal’s Name and Mailing Address
Name
Name
Street or Other Mailing Address
Street Address
City
State
Zip Code
City
State
Zip Code
5
Effective Date of Bond
6 Indicate fuel tax licenses covered by this bond.
Minimum $20,000 bond for each license:
Minimum $10,000 bond for:
Minimum $1,000 bond for:
Month
Day
Year
Motor Fuels Tax
Producer
Aircraft Fuels Tax
Compressed Fuel Tax
Name and Mailing Address of Surety Company
Name and Mailing Address of Agent
Name
Name
Street or Other Mailing Address
Street or Other Mailing Address
City
State
Zip Code
City
State
Zip Code
Email Address
Phone Number
Email Address
Phone Number
Condition of Bond
The individual or firm, as principal, and the surety company, both duly qualified and
authorized to transact business in the State of Nebraska, are jointly and severally
liable to the State of Nebraska, in the bond amount shown above.
The principal has made application for, or holds licenses or permits as indicated in
this bond. If the principal pays all taxes, penalties, and interest due, or to become
due, under the laws of Nebraska relating to the motor fuels tax programs and
complies with all statutory and regulatory provisions, then this obligation will be
void; otherwise, it will remain in full force and effect. The obligation of this bond
begins on the effective date indicated above.
The bond will continue until the above-named surety company provides written
notification of cancellation to the Nebraska Department of Revenue. At least 30
days’ notice of cancellation must be provided. The bond will be cancelled at the end
of the last day of the calendar month following the month that written notice of
cancellation was received. This does not discharge the principal and surety from any
liability already due, or to become due, under the laws of Nebraska guaranteed by
this bond before the date of cancellation.
sign
here
Signature of Principal
Phone Number
Date
Signature of Attorney-in-Fact or Authorized Surety Company Officer
Phone Number
Date
Signature of Agent
Phone Number
Date
Mail this bond to: Nebraska Department of Revenue, PO Box 98904, Lincoln, NE 68509-8904.
3-183-1973 Rev. 9-2021
Page 1
Supersedes 3-183-1973 Rev. 7-2020
Instructions
Who Must File. Every entity making application for a motor fuels or aircraft fuels producer, supplier, distributor,
wholesaler, importer, exporter, or compressed fuel retailer license who does not currently hold a valid fuel tax
license, is required to file a surety bond. A surety bond may also be required by the Nebraska Department of
Revenue (DOR) to ensure compliance with Nebraska motor fuels tax laws. When a licensee fails to file timely
returns, when tax has not been remitted, or when an audit indicates severe problems, a bond may be required.
When and Where to File. The bond and
Nebraska Motor Fuels License Application, Form
20MF, must be sent
together to the Nebraska Department of Revenue, PO Box 98904, Lincoln, Nebraska 68509-8904. If a bond or
application is received separately, it will be returned to the applicant. The forms may also be sent electronically
to the taxpayer’s motor fuels account representative. Please contact DOR to determine your assigned account
representative to whom the forms can be sent and for instructions regarding the secure submission of the forms.
Email. By entering an email address, the taxpayer acknowledges that DOR may contact the taxpayer by email.
The taxpayer accepts any risk to confidentiality associated with this method of communication. DOR will send
all confidential information by secure email or the State of Nebraska’s file share system. If you do not wish to
be contacted by email, write “Opt Out” on the line labeled “email address.”
Determination of Amount. The bond amount for a motor fuels producer, supplier, distributor, wholesaler,
importer, or exporter license is approximately three times the estimated average monthly tax liability, in an
amount not less than $20,000. The bond amount for an aircraft fuels supplier, distributor, wholesaler, importer,
or exporter license is approximately three times the estimated average monthly tax liability, in an amount not
less than $10,000. When no prior record of liability exists, applicants must estimate their potential liability.
The bond amount for a compressed fuel retailer is approximately two times the estimated average quarterly
tax liability, or three times the estimated average monthly tax liability, depending on the filing frequency. In
no instance will this be less than $1,000. When no prior record of liability exists, applicants must estimate their
potential liability.
The duration of this bonding requirement is at least one year. In the case of an exporter, the amount and
duration of the surety bond are fixed by DOR.
Failure to maintain a proper bond is cause for license or permit suspension or cancellation.
A
Nebraska Motor Fuels Tax Bond Rider, Form
70XN, must be filed to indicate the following changes to
existing bonds:
Change in name;
Change in ownership;
Change in form of ownership;
Change in amount of bond; or
Change in effective date of bond.
Combined Motor Fuels Tax Bond
Who May File. Any person applying for or holding two or more licenses or permits may, instead of filing a
separate bond for each license or permit, file a combined bond.
Determination of Combined Amount. The amount of a combined bond is the cumulative total of the amount
of the individual bonds that otherwise would be required. The Nebraska Schedule – Combined Motor Fuels
Tax Bond below must be completed when filing a combined bond.
For Additional Information. Please contact your account representative at the Nebraska Department of Revenue,
PO Box 98904, Lincoln, NE 68509-8904, call 800-554-FUEL (800-554-3835), or 402-471-5730. DOR’s website
is revenue.nebraska.gov/motor-fuels.
Nebraska Schedule — Combined Motor Fuels Tax Bond
Tax Program
Amount of Bond
1
2
3
4 Total of lines 1 through 3. Enter here and on line 4 on page 1 of this form ..............
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