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Petitioner, having sought review of an order of the Board of Finance and Revenue entered (or deemed entered) in this matter on the day of , 19 , and having procured the execution of this instrument for the purpose of complying with the Pennsylvania Rules of Appellate Procedure, the undersigned surety acknowledges itself bound and indebted to the Commonwealth of Pennsylvania in the amount of $(), which is 120% of the sum of $ ___ (taxes found due) and $() (penalty found due), the amount of taxes and penalty found due by the Board and remaining unpaid in this matter, to be paid as required by law.
Upon conclusion of this matter, if the petitioner satisfies the above identified order or any court order modifying or affirming that order and pays all costs, interest and any damages for delay that may be awarded, this obligation shall be void; otherwise it shall remain in full force.
Date ____________
______________________________________
(Name of Surety)
By
______________________________________
(Name and Title of Authorized Signatory)
210 Pa. Code r. 1782
The requirement of a bond for costs only (as where the full amount of the tax found due below has already been paid) has been eliminated.