Where Do you Need the Bond?

Select "All States/Federal Bonds" when applying for a federal bond, customs bond, H-2A farm labor bond, business service bond, lost instrument bond or lost stock certificate bond.

Choose the Bond Type

Arizona
Are you applying as an:*
We will contact you via email. Would you also like to receive a:*
We will use the phone number of the contact person for both text and phone messages

This is a 2 year bond that cannot be cancelled, as such, the premium quoted will be for the 2 year term. We will not be able to bill for this bond annually.

This is a 2 year bond, as such, the premium quoted will be for the 2 year term. We will not be able to bill for this bond annually.

About Your Bond

Please double check this information as this is exactly how your name will appear on your bond. Check to see if it should read your name, and/or your DBA or just your company name.
Address on Bond*
$
Third Party Administrator Program - Florida DHSMV*
Alcoholic Beverages...*
Choose 1
Bond Amount*
Call if bond request in excess of $100,000
National Provider Number
Please double check this information as this is exactly how your name will appear on your bond. Check to see if it should read your name, and/or your DBA or just your company name.
Obligee Address*
The Required Bond is:*
1000 Shares of XYZ Corporation
1000 Shares of XYZ Corporation
Have the Securites Been Endorsed?*
Have the securites been signed by the holder
Have the Securities Been Assigned to Another Party?*
Are the Lost Securities in Bearer Form?*
Bearer form means the security is traded without any record of ownership, so physical possession of the security is the sole evidence of ownership. Most securities issued today are in registered form.
Has Notice of Loss Been Given?*
Have you notified the transfer agent that the securities have been lost?
Has a Stop Notice Been Issued?*
Has the transfer agent issued a stop notice?
Address of Bank*
Double check, this information is required on your bond and if it is not correct, there will be a $35.00 rider fee to correct a wrong VIN number.
Camero, Pinto, Mustang, Etc.
$
Trailer, Motorcycle, etc.
Is this a salvage title vehicle?*

Surety1 cannot write a bond for salvaged vehicles.

Is there a certificate of lien satisfaction?*
Date Business Started (Approximate date is O.K.)*
Provide a description of the mobile home, vehicle, or vessel. Include any relevant details such as a VIN, serial number, make, model, and year.
Would you like an E&O?
Please select amount*
Type of Permit
Will a "Request for Reconveyance" be executed and delivered to the trustee?*
Please upload copy of the preliminary title report or fax it to (916)737-5737
No File Chosen
File uploads may not work on some mobile devices.
Have you been consistently licensed and bonded for at least 5 years?*
Please attached the letter from the VA appointing you as Fiduciary*
No File Chosen
File uploads may not work on some mobile devices.
Or fax the letter (916)737-5737
Please select amount
Please explain*
Bond is required by....
North Carolina has 2 types of mortgage broker bonds
Bond effective date:*
(Federal Tax ID Number)
Please Verify which of the following bond type:*
Choose one of the following*
Will the bond cover more than 1 premise?*

If more than 1 premise is to be included, email athe following information TTBbond@surety1.com:

  • Full name and address of each premise to be covered
  • Bond Amount for each premise, both operations coverage and withdrawal coverage
  • The registry number for each premise
Shipping Options*
PDF Upload (optional)
No File Chosen
File uploads may not work on some mobile devices.
If you have a bond form you'd like to upload to our system, please attach it here. Or, you may fax it to 916-737-5737

About Your Business

Business Type*
Business Address*
Is this the shipping Address for the bond?*
Shipping Address*
Are countersignature of checks required?*
By whom was the audit made?*
Are bank accounts reconciled by someone not authorized to deposit or withdraw therefrom?*

Business Service Bond Questions

Type of Business Service Bond*
Any Employee Dishonesty Losses in the Last 5 years?*
Are owners/officers to be covered?*
Are volunteers to be covered?*
Are independent contractors to be covered?*

About You

At Surety1, we take the security of your personal information very seriously. All customer information we collect is protected by 256-bit SSL encryption

Home Address*
Is this the shipping address?*
Where would you like the bond shipped?*
This is a:*
Are you married?*
Are You a U.S. Citizen?*
Home Address - Partner*
Are you married? - Partner
Do you own real estate?*
Have you ever been declined for a bond?*
Has any prior surety company ever paid a claim, cancelled, refused renewal, or denied an application for any person with 20% or more ownership in the business?*
Have you or your company ever had a pending lawsuit, unpaid judgement lien, or bankruptcy?*
Do you or any of your companies have pending lawsuits, unsatisfied judgements, or liens?*
Have you or any of your companies been the subject of any legal or administrative proceedings resulting in disciplinary action?*

Company Information Customs Bond

Legal Address of the Company*
Is this the Mailing Address of the Company?
Mailing Address of the Company*
Your Company is a*
The Above is:
Are there any Subsidiaries, Divisions or DBA's to be Named on the Bond?*
Is there a Second Subsidiary, Division or DBA to be Named on the Bond*
Is there a Third Subsidiary, Division or DBA to be Named on the Bond?*
Is there a Fourth Subsidiary, Division or DBA to be Named on the Bond?*
You Will Need to Have a Customs Broker Clearing your Entries

Need Help Finding a Customs Broker? Obtaining a Customs Broker

SPEAK WITH A LIVE CUSTOMS BOND EXPERT NOW: 877-654-2327

Tell us About Your Import Business

Have you EVER imported merchandise subject to anti-dumping duties?*
Is any of the merchandise listed on this CURRENT U.S. Custom Import Bond Application Subject to Anti-Dumping Duties*
Do You Have an Active Bond on File in ANY Port?*

ERISA Bonds

What is the expiration date of the bond?*
The Plan Sponsor is the organization or business that created and maintains the plan providing retirement or other benefits for its employees. For example, the Plan Sponsor of the ABC Company 401(k) Plan is the ABC Company. In some cases, however, the Plan Sponsor’s name may be different than the Plan Name.
Address
$
$
Must be at least 10% of the plan assets
Effective Date
Input "None" if no prior bond
Have there been any paid loses in the last three years?
$

Home Care Aide, $10k Employee Dishonesty Bond

As required by Califonria Health and Safety Code; 1796.37(a) (4)

Effective Date of the Bond
Applicant/Licensee Mailing Address*
Ship to this address?*
Home Care Organization Address
Ship to this address ?*
Shipping Address*
Shipping Options

The premium for this bond is $100.00 for 1 year or $250.00 for a 3 year term. The bond will be shipped upon receipt of payment. All major charge cards accepted.

Terms and Conditions

Any person who knowingly and with the intent to defraud any insurance company or person files and application containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime under applicable law, The applicants and indemnitors certify the truth of all statements in the application. By submitting the application, you authorize Surety Solutions Insurance Services, Inc. to provide information provided by you to the insurance companies represented by Surety Solutions Insurance Services, Inc., along with any additional insurance companies or insurance intermediaries necessary to complete your application for surety bond(s), and / or insurance. You also authorize Surety Solutions Insurance Services, Inc., the insurance companies represented by Surety Solutions Insurance Services, Inc., along with any additional insurance companies or insurance intermediaries necessary to complete your application for surety bond(s), and/or insurance to request from one or multiple credit bureaus reporting agencies, your credit bureau report including any ancillary credit scores or ratings and to check your credit and employment history.*
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