BOND RIDER To be attached to and form a part of. , Name and Address of Surety Bond Number , for as Principal, and Dated Name and Address of Owner/Operator as Surety, in favor of the Nebraska Secretary of State, Name of Surety It is understood and agreed that the Bond is changed or revised in the particulars as indicated below: That the effective date of the bond is has changed from to . Date Date Said Bond shall be subject to all its terms, conditions, and limitations, except as herein expressly modified. This Bond Rider shall become effective: . Date IN WITTNESS WHEREOF, has caused its corporate seal to be Name of Surety hereunto affixed this: Signature Date STATE OF NEBRASKA ) ) County of ) 223I, , do solemnly swear that I will support the Constitution of the United States and the constitution of the State of Nebraska, and that I will faithfully and impartially perform the duties of the office of General Notary Public according to law, and to the best of my ability. And I do further swear that I do not advocate, nor am I a member of any political party or organization that advocates the overthrow of the government of the United States or of this State by force or violence: and that during such time as I am in this position I will not advocate nor become a member of any political party or organization that advocates the overthrow of the government of the United States or of this State by force or violence. So help me God.224 Signature of Applicant personally appeared before me and is known by the undersigned to be the same person designated as principal in the foregoing bond and the identical person signing the oath of office of a general notary public. Subscribed and sworn to before me this day of , 20. Witness my hand and official seal at Notary Public , Nebraska. My Commission expires American LegalNet, Inc. www.FormsWorkFlow.com