Form TC-763C "Cigarette Tax Surety Bond" - Utah

What Is Form TC-763C?

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

Form Details:

  • Released on September 1, 2011;
  • The latest edition provided by the Utah State Tax Commission;
  • 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 TC-763C by clicking the link below or browse more documents and templates provided by the Utah State Tax Commission.

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Download Form TC-763C "Cigarette Tax Surety Bond" - Utah

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BOND NO.__ _ __ _ __ _ __ _ _
TC-763C.ai Rev. 9/11
CIGARETTE TAX SURETY BOND
KNOW ALL PERSONS BY THESE PRESENTS: That
___ __ __ __ _ __ _ __ _ __ _ __ _ _ __ _ _ _ __ _ _
__________________________________________________________
of (Street
Address)________ ___ __ __ __ ___ __ __ __ _ __ _ __ _ __ _ __ _ _ __ _ __ _ __ _
,
(City), County of
______ ___ ___ ___ _ __ ___ ___ _ __ _ __ _ __ _ __ _ __
, Utah (“Principal”), and
________________ __ ___ ___ _ __ ___ ____ _ __ _ __
, duly certified by the Utah Department
of Insurance (State of Utah certificate number
#_ ___ __ ___
__) to do business in the State of Utah, and with a rating
of at least B+ with the A.M. Best Company, (“Surety”), are jointly and severally held and firmly bound to the people of the
State of Utah in the sum of
____ __ ___ __ __ __ ___ ___ _ __ _ _
Dollars
($__ _ __ _ _ _
), as required
by Title 59, Chapter 14, Utah Code Ann. (1953, as amended), lawful money of the United States for the payment of which,
well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly, severally
and firmly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH, That
WHEREAS, the above bounden Principal has applied for a cigarette tax license within the State of Utah, and that pursuant
to the application, a license has been or is about to be issued.
WHEREAS, a demand has been made upon the above bounden Principal by the Utah State Tax Commission
(“Commission”) for security for the payment of cigarette taxes.
NOW, THEREFORE, if the above bounden Principal shall comply with all the provisions of Title 59, Chapter 14, Utah Code
Ann. (1953, as amended), and in particular, pay all taxes, interest, and penalties when due, the Surety shall have no obliga-
tion to perform under this bond.
Upon failure of the Principal to comply with any or all of the provisions of Title 59, Chapter 14, Utah Code Ann. (1953, as
amended), and in particular on the Principal’s failure to pay all taxes, interest, and penalties promptly when due, and when
demanded by the Commission, the Commission may make demand upon the surety for the payment of the amount of the
unpaid taxes, interest, and penalties by the Principal up to, but not to exceed the amount of the Surety’s liability as defined
by this bond, and in addition any costs or attorney’s fees incurred in collecting the same from the Surety.
This bond does not limit the liability of the Principal under Title 59, Chapter 14, Utah Code Ann. (1953, as amended).
The Commission, through its authorized agents, reserves the right, at any time, to require a bond of greater amount than
this bond whenever the Commission deems it necessary to comply with the provisions of Title 59, Chapter 14, Utah Code
Ann. (1953, as amended).
This bond shall remain in continuous force and effect until terminated as hereinafter provided. The Surety may at any time
terminate this bond by giving 30 days written notice by certified mail to the Utah State Tax Commission, Attention: Taxpayer
Services Division Director, Utah State Tax Commission, 210 North 1950 West, Salt Lake City, Utah 84134. Notwithstanding
termination, this bond shall remain in effect for the liability that accrued or was incurred prior to the date of termination,
regardless of whether the liability was assessed, established, known, due, or demanded by the Commission prior to the
date of termination.
The provisions of this bond shall be interpreted in accordance with the laws of the State of Utah.
IN WITNESS WHEREOF, the parties have executed this bond at _ _ __ _ __ _ __
_________________ ___ __ ___ _ , this _____ day of __ _ __ _ __ _ , 20_ __ .
EFFECTIVE DATE:
By _ _ __ _ __ _ __ _ __ _ __ _ _
Print Form
Principal
_ _ __ _ __ _ __ _ __ _ __ _ _
Surety
____________________________________
By _ _ __ _ __ _ __ _ __ _ __ _ _
Countersignature of Resident Agent
Attorney in Fact
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BOND NO.__ _ __ _ __ _ __ _ _
TC-763C.ai Rev. 9/11
CIGARETTE TAX SURETY BOND
KNOW ALL PERSONS BY THESE PRESENTS: That
___ __ __ __ _ __ _ __ _ __ _ __ _ _ __ _ _ _ __ _ _
__________________________________________________________
of (Street
Address)________ ___ __ __ __ ___ __ __ __ _ __ _ __ _ __ _ __ _ _ __ _ __ _ __ _
,
(City), County of
______ ___ ___ ___ _ __ ___ ___ _ __ _ __ _ __ _ __ _ __
, Utah (“Principal”), and
________________ __ ___ ___ _ __ ___ ____ _ __ _ __
, duly certified by the Utah Department
of Insurance (State of Utah certificate number
#_ ___ __ ___
__) to do business in the State of Utah, and with a rating
of at least B+ with the A.M. Best Company, (“Surety”), are jointly and severally held and firmly bound to the people of the
State of Utah in the sum of
____ __ ___ __ __ __ ___ ___ _ __ _ _
Dollars
($__ _ __ _ _ _
), as required
by Title 59, Chapter 14, Utah Code Ann. (1953, as amended), lawful money of the United States for the payment of which,
well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly, severally
and firmly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH, That
WHEREAS, the above bounden Principal has applied for a cigarette tax license within the State of Utah, and that pursuant
to the application, a license has been or is about to be issued.
WHEREAS, a demand has been made upon the above bounden Principal by the Utah State Tax Commission
(“Commission”) for security for the payment of cigarette taxes.
NOW, THEREFORE, if the above bounden Principal shall comply with all the provisions of Title 59, Chapter 14, Utah Code
Ann. (1953, as amended), and in particular, pay all taxes, interest, and penalties when due, the Surety shall have no obliga-
tion to perform under this bond.
Upon failure of the Principal to comply with any or all of the provisions of Title 59, Chapter 14, Utah Code Ann. (1953, as
amended), and in particular on the Principal’s failure to pay all taxes, interest, and penalties promptly when due, and when
demanded by the Commission, the Commission may make demand upon the surety for the payment of the amount of the
unpaid taxes, interest, and penalties by the Principal up to, but not to exceed the amount of the Surety’s liability as defined
by this bond, and in addition any costs or attorney’s fees incurred in collecting the same from the Surety.
This bond does not limit the liability of the Principal under Title 59, Chapter 14, Utah Code Ann. (1953, as amended).
The Commission, through its authorized agents, reserves the right, at any time, to require a bond of greater amount than
this bond whenever the Commission deems it necessary to comply with the provisions of Title 59, Chapter 14, Utah Code
Ann. (1953, as amended).
This bond shall remain in continuous force and effect until terminated as hereinafter provided. The Surety may at any time
terminate this bond by giving 30 days written notice by certified mail to the Utah State Tax Commission, Attention: Taxpayer
Services Division Director, Utah State Tax Commission, 210 North 1950 West, Salt Lake City, Utah 84134. Notwithstanding
termination, this bond shall remain in effect for the liability that accrued or was incurred prior to the date of termination,
regardless of whether the liability was assessed, established, known, due, or demanded by the Commission prior to the
date of termination.
The provisions of this bond shall be interpreted in accordance with the laws of the State of Utah.
IN WITNESS WHEREOF, the parties have executed this bond at _ _ __ _ __ _ __
_________________ ___ __ ___ _ , this _____ day of __ _ __ _ __ _ , 20_ __ .
EFFECTIVE DATE:
By _ _ __ _ __ _ __ _ __ _ __ _ _
Print Form
Principal
_ _ __ _ __ _ __ _ __ _ __ _ _
Surety
____________________________________
By _ _ __ _ __ _ __ _ __ _ __ _ _
Countersignature of Resident Agent
Attorney in Fact
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INDIVIDUAL ACKNOWLEDGMENT OF PRINCIPAL
STATE OF UTAH
SS
COUNTY OF
___________________
On this
_ __ __
day of
___________
, in the year 20
__ _
, before me personally appeared
_______________________
, to me
known and known to me to be the person, and described in, and who executed the foregoing instrument, and acknowledgment to me that he executed the same.
(NOTARY SEAL)
__ _ __ _ _ _ __ _ _ __ _
Notary Public
LLP/PARTNERSHIP OR FIRM ACKNOWLEDGMENT OF PRINCIPAL
STATE OF UTAH
SS
COUNTY OF
___________________
On this
_ __ __
day of
___________
, in the year 20
__ _
, before me personally appeared
_______________________
, to me
known and known to me to be of the firm of
____________________________________________
, described in, and who
executed the same as and for the act and deed of said firm.
(NOTARY SEAL)
_ __ _ __ _ __ _ __ _ __
Notary Public
CORPORATE ACKNOWLEDGEMENT OF PRINCIPAL
(TO BE COMPLETED BY CORPORATION WITH CORPORATE SEAL)
STATE OF UTAH
SS
COUNTY OF
___________________
On this
_ __ __
day of
___________
, in the year 20
__ _
, before me personally appeared
_______________________
, to me
known, who, being by me duly sworn, did depose and say: That he resides in
_________________________________
, that he is the
_______________________
of the
_______________
, the corporation described in and which executed the above instrument;
that he knew the seal of said corporation, and that he signed his name thereto by like order.
(CORPORATE SEAL)
(NOTARY SEAL)
__ _ __ _ _ _ __ _ _ __ _
Notary Public
CORPORATE ACKNOWLEDGEMENT OF PRINCIPAL/LLC
(TO BE COMPLETED BY LLC OR CORPORATION WITHOUT CORPORATE SEAL)
STATE OF UTAH
SS
COUNTY OF
___________________
On this
_ __ __
day of
___________
, in the year 20
__ _
, before me personally appeared
_______________________
, to me
known, who, being by me duly sworn, did depose and say: That he resides in
_________________________________
, that he is the
_______________________
of the
_______________
, the corporation which executed the above instrument and which is
described therein; that he signed the above mentioned instrument on behalf of said corporation; that he was authorized to do so.
(NOTARY SEAL)
_ __ _ __ _ __ _ __ _ __
Notary Public
AFFIDAVIT OF QUALIFICATION BY SURETY
STATE OF UTAH
SS
COUNTY OF
___________________
_______________________________________________
being first duly sworn, on oath deposes and says that he is the
___________________________
of said company, and that he is duly authorized to execute and deliver the foregoing obligations; that said
company is authorized to execute the same and has complied in all respects with the laws of Utah in reference to becoming sole surety upon bonds, undertakings
and obligations.
Subscribed and sworn to before me
_____
_______ ___ _
_ __
this
day of
20
______ ___ ___ __
_ __ _ __ _ __ _ __ _ __
My Commission expires:
(NOTARY SEAL)
Notary Public
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