Bond Number: Effective Bond Date:
of
(Principal) (Mailing address)
, and
(City and State) (Surety)
are held and firmly bound unto the State of Iowa, Division of Labor as the holder in the penal sum of
five thousand dollars ($5,000.00) lawful money of the United States, to the payment of which sum, the
Principal and Surety firmly bind themselves, their heirs, executors, successors, assigns and
administrators, jointly and severally.
This obligation arises because the Principal is a promoter of a boxing, wrestling, kickboxing and/or
mixed martial arts match or event in the State of Iowa. Iowa Code Chapter 91C requires the Principal file
this bond.
The Principal shall pay all taxes pursuant to 90A.9 and its rules as well as any penalties or other costs
that may become due thereunder.
This bond shall be continuous in nature until cancelled by the Surety with not less than thirty (30) days’
written notice to the Principal and to the Iowa Division of Labor.
The obligation of this bond shall be operative until released in the manner provided in Iowa Code
Chapter 91C.
Executed this day of , 20 .
Principal (signature)
Surety (signature)
Boxing | Wrestling
MMA | Kickboxing
Bond Form
Iowa Division of Labor
Athletic Commission
150 Des Moines Street
Des Moines, IA 50309-1836
Phone: 515-745-2632
Fax: 515-281-5361
athletics@iwd.iowa.gov
athletic.iowa.gov
06.17.2020
300-006
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