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*0-0-705-099*
*0-0-705-099*
Wyoming Department of Revenue
Excise Tax Division
122 West 25th Street, Herschler Bldg
Cheyenne, Wyoming 82002-0110
http://revenue.wyo.gov
STATE OF WYOMING
DEPARTMENT OF REVENUE
NON-RESIDENT CONTRACTOR SALES AND USE TAX BOND
COVERING A SINGLE CONTRACT
BOND NO.___________
KNOW ALL MEN BY THESE PRESENTS, that we the undersigned, ______
_______________________________________(name and form of business
organization of the principal), as Principal, and
_______________________________________(name of surety), a corporation
organized to do business in the State of Wyoming, as Surety, are held and firmly bound
unto the State of Wyoming in the sum of ___________________ Dollars
($___________), lawful money of the United States of America, for the payment of
which we bind ourselves, our legal representatives, successors and assigns, jointly and
severally, firmly by these presents.
WHEREAS, the above named Principal is a nonresident general or prime
contractor as defined by Wyo. Stat. § 39-16-301;
WHEREAS, the above named Principal has entered into a contract with
____________________________, dated ___________________ for
____________________________________________, a copy of which is attached and
made a part hereto;
WHEREAS, pursuant to Wyo. Stat. § 39-16-306(b), the Principal has elected to
deposit with the Department of Revenue a surety bond in the amount determined to be
sufficient by the Department of Revenue to secure the payment by the Principal of any
sales and use tax, penalty, and interest, which may accrue to the State of Wyoming in the
performance of the above referenced contract. Said taxes are imposed by the Selective
Sales Tax Act of 1937, as amended, and the Use Tax Act of 1937, as amended; and
WHEREAS, by executing this instrument the Surety does hereby bind and
obligate itself unto the State of Wyoming to secure the payment by the Principal of any
and all sales and sales and/or use taxes, penalty, and interest, which will accrue or which
have accrued since the commencement of operations by the Principal in the State of
Wyoming. The liability of the surety is on all sales and/or use tax, penalty, and interest
accrued, including taxes which predate the execution of this agreement.
NOW, THEREFORE, if the Principal timely pays to the State of Wyoming all
sales and use taxes which become due and payable under the above referenced contract
pursuant to the Selective Sales Tax Act of 1937, as amended, and the Use Tax Act of
1937, as amended;
THEN, this obligation shall terminate; otherwise it shall remain in force and effect.
The Surety may terminate its liability hereunder at any time by giving written
notice to the Department of Revenue and to the Principal; but such termination shall only
become effective thirty (30) days after the actual receipt of the written notice by the
Department of Revenue, and shall not negate any liability incurred hereunder on or prior
to the date of such termination.
Any action upon this bond will be governed by Wyoming law.
The State will not approve this bond if any changes or alterations have been made
to the printed text or entries on any portion of this form.
Non-Resident Contractor Sales and Use Tax Bond
__________________, Principal, and _________________,Surety
Bond No.________________Page 1 of 2
ETS Form 124 a (Rev 5/8/19)
