Form MMS-4072 Form MMS-4072 Royalty-in-Kind Contract Surety Bond

U.S. Department of the Interior
Minerals Management Service
Minerals Revenue Management

OMB Control Number 1010-0119
Expires February 28, 2009

ROYALTY-IN-KIND CONTRACT SURETY BOND
Form MMS-4072
DATE BOND EXECUTED
ROYALTY-IN-KIND CONTRACT SURETY
BOND
(See Instructions)
PRINCIPAL (Legal name and business address, including county)

BOND NO:

PRINCIPAL'S TYPE OF ORGANIZATION
[] INDIVIDUAL
[] JOINT VENTURE

[] PARTNERSHIP
[] CORPORATION

STATE OF INCORPORATION

STATE LICENSE TO TRANSACT SURETY
BUSINESS

SURETY (name and business address, including county)

STATE OF INCORPORATION

RECITALS
1. Principal and surety are bound to Minerals Management Service (MMS) in the
sum of __________________________________________________________________________________________________
United States Dollars ($________________________), for the payment of which principal and surety jointly and
severally bind themselves, their successors, assigns, and legal representatives.
2. Successful execution of this bond is necessary before the principal and MMS can enter into Royalty-InKind (RIK) Contract Number ____________, herein called the original contract, which will have an effective
date of _____________________ and will be executed in the Denver Federal Center, County of Jefferson, State
of Colorado.
SECTION ONE
DURATION
This obligation shall run continuously and shall remain in full force and effect until and unless the
bond is terminated and canceled as provided herein or as otherwise provided by law.
SECTION TWO
LIMITATION
This bond covers only the original contract and any extensions thereof that are granted by MMS including
the time period needed for MMS to reconcile the contract, with or without notice to surety and during the
life of any guaranty required under the contract.
SECTION THREE
CONDITION OF OBLIGATION
If principal fully performs its obligation(s) under the contract and any extensions thereof that are
granted by MMS including the contract reconciliation period, this obligation shall be void; otherwise this
obligation shall remain in full force and effect, subject only to the provisions of this bond.
SECTION FOUR
NOTICE
The surety is liable upon discovery by MMS and notification to surety of any fact or circumstance showing
a claim hereunder.
SECTION FIVE
TERMINATION
Surety may terminate its obligation hereunder by notifying MMS by registered letter 30 or more days prior
to the termination date, but such notice shall not affect this agreement in respect to any obligation which
may have arisen prior to the termination date.

Form MMS-4072 (Revised 08/2008)
Page 1 of 3

U.S. Department of the Interior
Minerals Management Service
Minerals Revenue Management

OMB Control Number 1010-0119
Expires February 28, 2009

ROYALTY-IN-KIND CONTRACT SURETY BOND
Form MMS-4072
SECTION SIX
EXTENT OF LIABILITY
The maximum amount of the liability of surety by virtue of this obligation shall be
______________________________________________________________________________________________________
United States Dollars ($_____________________________), plus accrued interest due on this amount.
SECTION SEVEN
MODIFICATION OF ORIGINAL CONTRACT
Any deviations from, additions to, extensions of, or modifications in the obligations of the original
contract may be made without the consent or knowledge of surety and without in any way releasing surety from
liability under this bond.
SECTION EIGHT
SEVERABILITY
If any one or more of the provisions of this bond are determined to be illegal or unenforceable by a
court of competent jurisdiction, all other provisions shall remain effective.
SECTION NINE
BINDING EFFECT OF AGREEMENT
This bond shall be binding on surety and its successors, assigns, and legal representatives.
In witness whereof, principal and surety have executed this bond and
______________________ (designated place of execution) on _______________________.

affixed

their

seals

Principal
Signature (S)

1.

2.

3.

Name(s) &
Title(s)
(Typed)

1.

2.

3.

Corporate
Or
Notary
Seal

Acknowledgement (required for notary seal):
Subscribed to and sworn to before me this _______ day of ______________________.
__________________________________
Notary Public
__________________________________
Address (business or residence)
My commission expires:

___________________________
CORPORATE SURETY

NAME&
ADDRESS

LIABILTIY LIMIT

SIGNATURE(S)

1.

2.

NAME(S) &
TITLE(S)
(Typed)

1.

2.

Corporate Seal

Form MMS-4072 (Revised 08/2008)
Page 2 of 3

at

U.S. Department of the Interior
Minerals Management Service
Minerals Revenue Management

OMB Control Number 1010-0119
Expires February 28, 2009

ROYALTY-IN-KIND CONTRACT SURETY BOND
Form MMS-4072

INSTRUCTIONS
This form is authorized for use in connection with MMS Royalty-In-Kind contracts. Any deviation from
this form will require the written approval of the Program Director for RIK, MMS.
Corporations executing the bond as sureties must appear on the Department of the Treasury's list of the
approved sureties and must act within the limitation listed therein.
An authorized person shall sign the bond. Any person signing in a representative capacity (e.g., an
attorney-in-fact) must furnish evidence of authority if that representative is not a member of the firm,
partnership, or joint venture, or an officer of the corporation involved.
Type the name and title of each person signing this bond in the space provided. Corporate or notary seals
must be affixed as applicable. Notary seals require acknowledgment.

Paperwork Reduction Act of 1995 (PRA) Statement: The PRA (44 U.S.C. 3501 et seq.) requires us to inform you that we collect this
information to allow small refiners to provide surety to the Federal Government. The MMS uses the information to collect monies from financial
institutions if the small refiners do not report and pay. Responses are required to obtain a benefit (30 CFR 208.11), i.e., to be awarded an RIK
contract. Proprietary information is protected in accordance with standards established by the Federal Oil and Gas Royalty Management Act of
1982 (30 U.S.C. 1733), the Freedom of Information Act [5 U.S.C. 552(b), (4)], and the Department regulations (43 CFR 2). An agency may not
conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB Control Number.
Public reporting burden for this form is estimated to average 10 hours per response, including the time for reviewing instructions, gathering and
maintaining data, and completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of this form to the
Information Collection Clearance Officer, Minerals Management Service, Mail Stop 5438, 1849 C Street, NW., Washington, DC 20240.

Form MMS-4072 (Revised 08/2008)
Page 3 of 3