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Utah Beer Wholesaling Bond

$1,000.00 | Not Saved

Terms and Conditions

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Desired Effective Date:

Bond Amount: $1,000.00

This bond has a fixed amount which means you don't need to worry about selecting the correct amount for your bond.

Terms & Conditions

1. You must answer the following questions accurately. Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance containing any false information or conceals for the purpose of misleading information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties.

2. The quote is 100% free and there is no cost for the application process should you decline the offer.

3. In most cases you will receive a quote immediately. However, some applicants require further review by a human in order to obtain the lowest rate due to the multiple considerations involved.

4. Due to the unique nature of this specialty program all premiums and/or fees are considered fully earned, and are not refundable even if your bond is cancelled midterm.

5. Surety Solutions, LLC reserves the right to change the terms of this agreement at any time without notice.

6. This agreement shall serve as the writing required pursuant to the rules set forth by your Department of Insurance. *To help protect against fraud your Internet IP address will be recorded
7. By typing your name below you acknowledge that you are the person indicated, have read, understand and agree to the terms and conditions set forth, and accept this electronic signature as the equivalent to a wet original signature.
8. By submitting this application I agree to allow Surety Solutions LLC or the issuing company to make any inquiries it deems necessary, including but not limited to obtaining my Consumer Report from a Consumer Reporting Agency, to reach a decision on this application.

Principal Information

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Personal Information

Applicant's first name
Applicant's middle name
Applicant's last name
Applicant's name suffix
Applicant's social security number
Applicant's date of birth mm/dd/yyyy
Applicant's driver's license number
Applicant's driver's license state
Applicant's job title
Applicant's phone number (###) ###-####
Applicant's email address

Residence Address

Applicant's residential address
Applicant's residential address suite/apt number
Applicant's residential zip code
Applicant's city of residence
Applicant's county of residence
Applicant's state of residence

Mailing Address

Applicant's mailing address
Applicant's mailing apt/suite number
Applicant's mailing zip code
Applicant's mailing city
Applicant's mailing county
Applicant's mailing state

Other Information

Applicant's marital status
Spouse's full name
Spouse's social security number
Spouse's date of birth
Does applicant currently own or rent their home?
Date applicant purchased home
Price home was purchased for
Approximate current market value for the home
Approximate remaining balance on the home loan

Company Information

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Basic Company Information

Company's name
Doing Business As
Date the company was formed
Select the type of organization for the company
State that the company is filed under
Federal ID / Tax Identification number for the company
Number of owners in the company
Number of individuals that the company employs

Physical Address

Company's physical address
Company's physical address suite/apt number
Company's physical address zip code
Company's physical address city
Company's physical address county
Company's physical address state

Mailing Address

Company's mailing address
Company's mailing apt/suite number
Company's mailing zip code
Company's mailing city
Company's mailing county
Company's mailing state

Contact Information

Person to contact regarding this application
Company phone number to be used as a contact number
Company Fax Number
Email to be used as primary email contact regarding this application

Additional Information

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By typing your name below you acknowledge that you are the person indicated, have read, understand and agree to the terms and conditions set forth, and accept this electronic signature as the equivalent to a wet original signature.

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