20151216-IR-760150445NRA December 10, 2015 Bulletin 223 Public Official Bonds

DEPARTMENT OF INSURANCE

December 10, 2015 Bulletin 223 Public Official Bonds

This bulletin is directed to all writers of bonds used to fulfill the requirements of IC 5-4-1 and all public officials, employees, and contractors required to file such bonds. It has become apparent to the Department that the public interest will be best served by the designation of a single form of bond under IC 5-4-1-18(i) (version effective January 1, 2016).

The Department has consulted with the State Board of Accounts and the Indiana Archives and Records Administration and now prescribes the three bond forms attached to this bulletin. A company wishing to use a prescribed bond must file it with the Department pursuant to IC 27-1-22-4. These bonds are subject to a file-and-use requirement, which means they may be used in the market as soon as they are filed. Beginning January 1, 2016, the bond filed with the county recorder and local fiscal officer on behalf of a public official, employee, or contractor required to file such a bond under IC 5-4-1 must be on the prescribed form.

At this time, the Department is not prescribing a single form to be used for a crime insurance policy used to comply with IC 5-4-1. Until further notice, any crime insurance policy marked "filed" by the Department may be considered prescribed pursuant to IC 5-4-1-18(i).

INDIANA DEPARTMENT OF INSURANCE

______________________________________

Stephen W. Robertson

Insurance Commissioner

Attachments

	PUBLIC OFFICIAL BOND
	State Form 55947 (11-15)
	Approved by State Board of Accounts, 2015
	INDIANA DEPARTMENT OF INSURANCE
	Bond number ___________________________________________

_____________________________________________________, as Principal, and ____________________________________, as Surety, as well as all heirs, executors, and administrators of the Principal and Surety, are bound, jointly and severally, to the State of Indiana, in the amount of $ ____________, if subparagraph (b) is violated. In all other respects, the following conditions apply to this Public Official Bond.

a) The Principal is duly elected, commissioned, appointed, or employed as ________________ for _________________in the State of Indiana.

b) The Principal shall faithfully perform and fulfill his or her duties of the position named in subparagraph (a); including compliance with IC 5-11 and paying over on demand to the persons entitled or authorized to receive the same, all moneys that may come into his or her hands during the term of this Public Official Bond.

c) The term of this Public Official Bond is for a one (1) year term beginning on the_____________ day of ____________, 2______ and ending on the _________day of _____________, 2__________.

d) This Public Official Bond cannot be continued, extended, or renewed as provided by IC 5-4-1-18(m).

e) This Public Official Bond complies with IC 5-4-1-18, and any conflict between this bond and the Indiana Code shall be resolved in favor of the statutory provisions.

f) The Legislature may change, modify, or repeal any relevant law now in force and exact any and all laws during the existence of this Public Official Bond, but this Public Official Bond will remain in full force and effect, except for that which was directly altered by the change in law.

			(Seal)
	By
Attorney in Fact

Accepted and approved this _____________ day of ______________, 2_____________

State of Indiana, _____________________________________ County, ss:

Personally appeared before me, __________________________________________________ in and for said County and State aforesaid, ____________________________________________ who being sworn, upon his or her oath says: "I will support the Constitution of the United States and of the State of Indiana, and I will faithfully, honesty, and impartially fulfill the duties of the office of __________________________________ to the best of my skill and ability."

____________________________________________________

Subscribed and sworn to before me, this __________________ day of _____________________, ________________

	IN WITNESS WHEREOF, I have hereunto set my hand affixed the seal of said _______________________ at ______________________ this day and year above written.

I, _______________________ of the ______________________________ do certify the above to be a true and correct copy of the official oath of _____________________________ in and for said County as the same is endorsed on his or her commission.

IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said ____________________ , at _____________, this ________________ day of ______________ , A.D._________________

	_______________________________________________________
	_______________________________________________________

ACKNOWLEDGMENT OF PRINCIPAL

State of Indiana, __________________________ County, ss:

Personally appeared before me, _____________________________________________________

_______________________________________________________________________________________________

Principal upon the bond appearing on the reverse side hereof and acknowledges the execution of said bond

This ______________________________ day of _______________________, _______________________

	__________________________________________
	Notary Public

__________________________________________________________

Expiration date of commission, (if Notary Public)(month, day, year)

ACKNOWLEDGMENT OF SURETY

State of Indiana, __________________________ County, ss:

Comes now ___________________________ by ____________________________________________ its agent, surety upon the bond appearing on the reverse side hereof and acknowledges the execution of said bond this ____________________ day of____________________________ and confirms compliance with IC 5-4-1-18(i)

	__________________________________________
	Notary Public

__________________________________________________________

Expiration date of commission, (if Notary Public)(month, day, year)

	PUBLIC OFFICIAL NAME SCHEDULE BOND
	State Form 55946 (11-15)
	Approved by State Board of Accounts, 2015
	INDIANA DEPARTMENT OF INSURANCE
	Bond number ___________________________________________

_____________________________________________________, as Principal, and ____________________________________, as Surety, as well as all heirs, executors, and administrators of the Principal and Surety, are bound, jointly and severally, to the State of Indiana, in the amount shown in the attached schedule if subparagraph (a) is violated. In all other respects, the following conditions apply to this Public Official Bond.

a) Any Public Official or Employee who is named in the schedule attached, shall faithfully perform and fulfill his or her duties, including compliance with IC 5-11 and paying over on demand to the persons entitled or authorized to receive the same, all moneys that may come into his or her hands during the term of this Public Official Bond.

b) The term of this Public Official Bond is for a one (1) year term beginning on the ________________ day of _______________________, 2__________ and ending on the ________________ day of _______________________, 2__________.

c) This Public Official Bond cannot be continued, extended, or renewed as provided by IC 5-4-1-18(m).

d) This Public Official Bond complies with IC 5-4-1-18, and any conflict between this bond and the Indiana Code shall be resolved in favor of the statutory provisions.

e) The Legislature may change, modify, or repeal any relevant law now in force and exact any and all laws during the existence of this Public Official Bond, but this Public Official Bond will remain in full force and effect, except for that which was directly altered by the change in law.

f) Automatic coverage is granted for the first thirty days of service of any Public Official or Employee succeeding one listed in the schedule. Provided, however, that the automatic coverage granted shall be void and of no effect unless during the said thirty day period a written request has been made to add the Public Official or Employee to the schedule and the Surety by written acceptance has consented thereto.

Dated this _____________________ day of __________________ , 2_______________

By _____________________________

Attorney in Fact                 

Bond number______________________________ 

Schedule of Public Officials and Employees effective (month, day, year) ______________________________ 

Schedule Number		Name of Public Official or Employee	Name of Position	Amount of Bond
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	PUBLIC OFFICIAL POSITION SCHEDULE BOND
	State Form 55948 (11-15)
	Approved by State Board of Accounts, 2015
	INDIANA DEPARTMENT OF INSURANCE
	Bond number ___________________________________________

_____________________________________________________, as Principal, and ____________________________________, as Surety, as well as all heirs, executors, and administrators of the Principal and Surety, are bound, jointly and severally, to the State of Indiana, in the amount shown in the attached schedule if subparagraph (a) is violated. In all other respects, the following conditions apply to this Public Official Bond.

a) Any Public Official or Employee while occupying a position named in the schedule attached, shall faithfully perform and fulfill his or her duties, including compliance with IC 5-11 and paying over on demand to the persons entitled or authorized to receive the same, all moneys that may come into his or her hands during the term of this Public Official Bond.

b) The term of this Public Official Bond is for a one (1) year term beginning on the ____________ day of ____________, 2____________ and ending on the __________ day of ____________, 2__________________.

c) This Public Official Bond cannot be continued, extended, or renewed as provided by IC 5-4-1-18(m).

d) This Public Official Bond complies with IC 5-4-1-18, and any conflict between this bond and the Indiana Code shall be resolved in favor of the statutory provisions.

e) The Legislature may change, modify, or repeal any relevant law now in force and exact any and all laws during the existence of this Public Official Bond, but this Public Official Bond will remain in full force and effect, except for that which was directly altered by the change in law.

Dated this _____________________ day of __________________ , 2_______________

By _________________________________

Attorney in Fact                    

Bond number______________________________ 

Schedule of Position - effective (month, day, year) ______________________________ 

Schedule Number		Name of Position	Number of Public Officials or Employees	Amount of Bond
1.
2.
3.
4.
5.
6.
7.
8.
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Posted: 12/16/2015 by Legislative Services Agency

DIN: 20151216-IR-760150445NRA

Composed: Nov 01,2016 2:07:51AM EDT

A PDF version of this document.