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Get Form 928

OMB No. 1545-0725 Expires 3-31-96 gasoline, original bond diesel fuel, or strengthening bond superseding bond Enter the effective date of bond issued aviation fuel excise tax. Bonding Telephone No. ( Bond is given by ) Name Address as principal and Name Address as surety. As principal and surety, we are obligated to the United States in the amount of dollars ($ ). We also jointly and severally obligate our heirs, executors, administrators, successors, and assigns for the pay.

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