MARYLAND FORM WINE BOND 366 Comptroller of Maryland Revenue Administration Division Licensing & Registration PO Box 2999 Annapolis, MD 21404 410-260-7980 www.marylandtaxes.com ATT Use Only Approved ______________ Date __________________ Bond Number: ______________ KNOW ALL PERSONS BY THESE PRESENTS, that we hereinafter called the Principal, and the laws of the State of , , a corporation incorporated under , hereinafter called the Surety, are held and firmly bound unto the State of Maryland in the full and just sum of ONE THOUSAND ($1,000.00) DOLLARS, lawful money of the United States of America, to be paid to the said State of Maryland, or its assigns, to which payment well and truly to be made and done we bind ourselves, or heirs, executors, administrators and successors, jointly and severally, firmly by these presents. Sealed with our respective seals and dated this day of , . WHEREAS, the above bounden principal is engaged or proposes to engage or proposes to engage in the business of selling wine within the State of Maryland, and WHEREAS, pursuant to Section 13-825, Tax-General Article of the Annotated Code of Maryland as amended, this bond is required to be given and deposited with the Comptroller of the State of Maryland. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such, that if the above bounden principal shall promptly file true reports with the Comptroller of the State of Maryland as required by law, and shall well and truly pay to the said Comptroller any and all wine taxes which are now and may hereafter be levied or imposed by the State of Maryland, together with any and all penalties and interest thereon, and shall faithfully comply with all of the provisions of Tax General Article of the Annotated Code of Maryland as amended, then this obligation to be void, otherwise to be and remain if full force and virtue. This Bond shall remain in full force and effect until canceled in accordance with the provisions of said Tax-General Article. TO BE COMPLETED BY SURETY TO BE COMPLETED BY LICENSEE ____________________________________________________________ Name of Surety ____________________________________________________________ Name of Principal ____________________________________________________________ Signature of President/Attorney-In-Fact ____________________________________________________________ Signature of Owner, Partner or Officer Attest: _______________________________________________________ Witness: ______________________________________________________ NOTE: CANCELLATION OF THIS BOND REQUIRES A 60 DAY NOTICE COM/RAD ATT-6 14-49 02/14 American LegalNet, Inc. www.FormsWorkFlow.com