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   CST-282                                      NONRESIDENT CONTRACTORS                                               West Virginia 
   REV 02/2022        CONSUMERS SALES AND SERVICE AND USE TAX                                                           State Tax 
                                                              BOND                                                    Department

   CHECK IF UMBRELLA CORPORATE SURETY BOND                                          BOND NUMBER

                                             KNOW ALL MEN BY THESE PRESENTS:
 1 That we,
 2

 3 As principal, and
 4
   a  ﬁrm and/or a corporation authorized to do business in the State of West Virginia, as Surety, are held and   rmlyﬁbound unto the 
   State of West Virginia in the just and full sum of
 5                                   Dollars ($                                     ) to the payment whereof well and truly to make, 
   we bind ourselves, our heirs, executors administrators, successors, and assigns, jointly and severally,  ﬁrmly by these presents.
 6 WHEREAS, the above bound Principal is a nonresident contractor within the meaning of Chapter 11, Article 15, of the O   cialﬃ
   Code of West Virginia of 1931, as amended, and whereas the Tax Commissioner of the State of West Virginia has required the said 
   Principal to deposit a bond, in accordance with the provisions of Chapter 11, Article 15 Section 8b of the said Code of West Virginia;

   NOW THEREFORE, if the said Principal shall in all respects fully comply with the provisions of Chapter 11, Articles 15 and 15A 
   of the said Code of West Virginia and the rules and regulations adopted and promulgated thereunder, and shall account for and 
   pay over all Consumers Sales and Use Taxes and penalties for which the said Principal shall be liable, and shall protect and save 
   harmless the State of West Virginia from any loss arising from the failure of the Principal to pay such Consumers Sales and Use 
   Taxes and penalties, for any cause whatsoever, then this obligation to be void; otherwise, to remain in full force and e ﬀect.

   The Principal hereby waives the secrecy provisions of West Virginia Code 11-10-5(d) and authorizes the West Virginia State Tax 
   Department to release to the surety company information necessary to  ﬁle a proof of claim concerning any tax liability covered by 
   this bond and accruing during the e ﬀective dates of this bond.

 7 This bond shall beﬀe  ective from the         day of                                            ,

   IN WITNESS WHEREOF the said principal has hereunder set his or its handﬃa   xed his or its seal, and the said surety has caused 
   its corporate name to be signed hereto and its corporate seal to be hereunto a   xedﬃ by its duly authorized o   cerﬃor agent and 
 8 executed this instrument this                 day of                                            ,

        PRINCIPAL CORPORATE SEAL 

11                                   9  (PRINCIPAL)                                                                     (SEAL) 
                                        BY:
                                        TITLE
                                     10 (Must be President or                                                           (SEAL)
                                        Vice-President)

        PRINCIPAL CORPORATE SEAL 

14                                   12 (SURETY)                                                                        (SEAL) 
                                        BY: 
                                        TITLE 
                                     13 (Must be President or                                                           (SEAL)
                                        Vice-President)

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                  ACKNOWLEDGEMENT BY PRINCIPAL IF INDIVIDUAL OR PARTNERSHIP
1
  STATE OF 
2
  COUNTY OF 
3
  TO WIT, I 
                           A NOTARY PUBLIC IN AND FOR THE COUNTY AND STATE AFORESAID, DO HEREBY CERTIFY THAT 
4
            WHOSE NAME IS SIGNED TO THE FOREGOING WRITING, HAS THIS DAY ACKNOWLEDGED THE SAME BEFORE ME IN MY SAID COUNTY.
5
  GIVEN UNDER MY HAND THIS    DAY OF                                       ,
6
                                     7
                                                                                  NOTARY PUBLIC 

                                     8
                  NOTARY SEAL          MY COMMISSION EXPIRES ON THE DAY OF                                                ,
            ACKNOWLEDGEMENT BY PRINCIPAL IF CORPORATION OR LIMITED LIABILITY COMPANY 
9
  STATE OF 
10
  COUNTY OF 
11
  TO WIT, I 
                           A NOTARY PUBLIC IN AND FOR THE COUNTY AND STATE AFORESAID, DO HEREBY CERTIFY THAT 
12
13
  WHO AS,                                                                         SIGNED THE FOREGOING WRITING FOR 
14
    A CORPORATION/LLC HAS THIS DAY, IN MY SAID COUNTY, BEFORE ME, ACKNOWLEDGED, THE SAID WRITING TO BE THE ACT AND DEDD OFR THE SAID CORPORATION/LLC
15
  GIVEN UNDER MY HAND THIS    DAY OF                                       ,
16
                                     17
                                                                    NOTARY PUBLIC 

                                     18
                  NOTARY SEAL          MY COMMISSION EXPIRES ON THE DAY OF                                                ,
                              ACKNOWLEDGEMENT BY SURETY
19
  STATE OF 
20
  COUNTY OF 
21
  TO WIT, I 
                           A NOTARY PUBLIC IN AND FOR THE COUNTY AND STATE AFORESAID, DO HEREBY CERTIFY THAT 
22
23
  WHO AS,                                                                         SIGNED THE FOREGOING WRITING FOR 
24
     A CORPORATION, HAS THIS DAY, IN MY SAID COUNTY, BEFORE ME, ACKNOWLEDGED, THE SAID WRITING TO BE THE ACT AND DEDD OFR THE SAID CORPORATION
25
  GIVEN UNDER MY HAND THIS    DAY OF                                       ,
26
                                     27
                                                                    NOTARY PUBLIC 

                                     28
                  NOTARY SEAL          MY COMMISSION EXPIRES ON THE DAY OF                                                ,
  APPROVED AS TO SUFFICIENCY OF FORM AND MATTER OF EXECUTION        ATTORNEY GENERAL 

THIS        DAY OF ,BY

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CST-282
Bond Preparation Instructions

IF PRINCIPAL IS AN INDIVIDUAL OR PARTNERSHIP:
● Complete the bond, lines (1) through (11);
● Have Notary complete the applicable section of acknowledgement titled,
Acknowledgment by Principal if Individual or Partnership, on the back of bond.

IF PRINCIPAL IS A CORPORATION:
● Complete the bond, line (1) through (11);
● Have Notary complete the applicable section of acknowledgement titled,
Acknowledgment by Principal if Individual or Partnership, on the back of bond;
● Affix raised Surety Seal to bond and to Power of Attorney.

SURETY:
● Complete applicable portion of bond;
● Have Notary complete applicable section of acknowledgement titled, Acknowledgement
by Surety, on the back of the bond;
● Attach Power of Attorney to bond if surety signatory is an attorney in fact;
● Affix raised Surety Seal to bond and to Power of Attorney.

ACKNOWLEDGMENT PREPARATION INSTRUCTIONS

If principal is an individual or partnership, have notary complete lines (1) through (8).
If principal is a corporation or llc, have notary complete lines (9) through (18).
Surety must have notary complete lines (19) through (28).
Notaries must:
ACKNOWLEDGMENT BY PRINCIPAL IF INDIVIDUAL OR PARTNERSHIP
1. Enter name of State.
2. Enter name of County.
3. Enter name of Notary Public witnessing transactions.
4. Enter name of Principal covered by bond if individual or partnership. (Must be Owner of
Sole Proprietorship or General Partner of Partnership)
5. Notary enters date bond was witnessed. Must be the same as or later than signature
date.
6. Affix Notary Seal.
7. Notary affixes his/her signature.
8. Notary enters commission expiration date.

ACKNOWLEDGEMENT BY PRINCIPAL IF INDIVIDUAL OR PARTNERSHIP
9. Enter name of State.
10. Enter name of County.
11. Enter name of Notary Public witnessing transactions.
12. Enter name of Corporate or LLC Officer signing bond

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13. Enter Title of Officer signing bond. (Must be President or Vice President of Corporation;
Manager or Managing Member of Limited Liability Company)
14. Enter name of Company or Corporation.
15. Notary enters date bond was witnessed. Must be the same as or later than signature
date.
16. Affix Notary Seal.
17. Notary affixes his/her signature.
18. Notary enters commission expiration date.

ACKNOWLEDGMENT BY SURETY
19. Enter name of State.
20. Enter name of County.
21. Enter name of Notary Public witnessing transactions.
22. Enter name of person having power of attorney to bind Surety Company.
23. Enter Title of person binding Surety Company.
24. Enter name of Insurance Company (Surety).
25. Notary enters date bond was witnessed. Must be the same as or later than signature
date.
26. Affix Notary Seal.
27. Notary affixes his/her signature.
28. Notary enters commission expiration date.

POWER OF ATTORNEY INSTRUCTIONS

Power of attorney for surety must be attached showing that it was in full force and effect on the
signature date indicated on the face of the bond. A raised corporate seal must also be affixed to
the Power of Attorney form.
● Name of attorney in fact must be listed.
● Power of Attorney may not exceed imposed limitations.
● Certificate date, the signature date of bond must be entered.
● Signature of authorizing official must be affixed. (Signature may be facsimile).
● Raised seal must be affixed.

MAILING INSTRUCTIONS

All bond forms must be submitted to and approved by the Department of Tax and Revenue
before commencing any contracting activity in West Virginia. Bond forms must be mailed to:
West Virginia State Tax Department, P. O. Box 1826, Charleston, West Virginia 25327-1826
Please sign this report and mail to :
West Virginia State Tax Department
P. O. Box 1826
Charleston, West Virginia 25327-1826

If you have any questions about these reporting procedures, please contact the West Virginia
State Tax Department, Tax Account Administration Division, 1001 Lee Street East, Charleston
WV 25301-1725, or call (304) 558-3333. You can also visit our website: www.wvtax.gov

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