State of Illinois
Dance Studio Bond
Secretary of State Index Department
111 E. Monroe
Springfield, IL 62756
217-782-7017
www.cyberdriveillinois.com
1. This bond must be the greater of the following:
A. $10,000 or
B. 10 percent of the dance studio’s gross income from the studio business in this state during the studio’s last fiscal year.
2. A copy of this bond must be furnished to the Illinois Secretary of State and must be accompanied by a declaration under penalty
of perjury signed by the owner of the studio stating the dance studio’s gross income from the dance studio business in this state
during the last fiscal year.
Bond of Dance Studio to the People of the State of Illinois
Bond Number: ___________________________________ Premium $: ____________________________
We, _____________________________________________________________________________________________, as Principal, a
dance studio, doing business under the firm name and style of __________________________________________________________
as Principal, and ___________________________________________________________________________________, a corporation,
created, organized and existing under and by virtue of the laws of the State of ____________________________________________,
and an admitted surety insurer, as Surety, are held and firmly bound unto the people of the State of Illinois in the penal sum of
____________________ Dollars ($_________________), lawful money of the United States of America, for which payment well and
truly to be made we bind ourselves, our heirs, executors, administrators and assigns, jointly and severally, firmly by these presents.
The conditions of the above obligation is such that:
Whereas, the above bounden Principal is engaged in business of offering dance studio lessons and other services within the meaning
of Section 2(b) of the Dance Studio Act and is required by the provisions of Section 12 of the Dance Studio Act to furnish a bond
conditioned as herein set forth;
Now, therefore, if said Principal and any and all agents and employees representing said Principal shall faithfully and honestly conduct
their business in accordance with the provisions of Section 2(b) of the Dance Studio Act and shall pay any person entering into a
contract, with Principal for dance studio lessons as the same are defined in said Dance Studio Act any damages suffered by such
person by reason of fraud, dishonesty or failure to provide the lessons or services of the studio in the performance of such contract,
then this obligation shall be void, otherwise to remain in full force and effect.
This bond is subject to the following provisions:
1. That any person claiming against this bond may maintain an action at law on his own name against the Principal and Surety.
2. That the total aggregate liability of Surety to all persons for breaches of the conditions of this bond shall in no event exceed the
penal sum above set forth.
3. That the Surety may cancel this bond and be relieved of further liability hereunder by giving 30 days written notice to the
Secretary of State of the State of Illinois and the Principal. However, such cancellation shall not affect any liability incurred or
accrued hereunder prior to the termination of that 30-day period.
4. That this bond shall remain in force and effect beginning on the _______ day of _________________, 20_______
and ending on the _______ day of _________________, 20_______.
Printed by authority of the State of Illinois. December 2009 50 I 222
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Printed by authority of the State of Illinois. December 2009 50 I 222
If a corporation, two officers sign below.
___________________________________________________
B
y ________________________________________________
___________________________________________________
___________________________________________________
By ________________________________________________
___________________________________________________
I, ________________________________________________ certify that __________________________________________________
__________________________________________________ who are each personally known to me to be the same persons whose
names are subscribed to the foregoing instrument; appeared before me this day in person, and acknowledged that they signed and
delivered said instrument as their free and voluntary act, for the uses and purposes therein set forth.
Corporation Principal
Title of Official
Title of Official
If an individual, sign below; if a co-partnership, all partners
sign below.
___________________________________________________
_
__________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
By ________________________________________________
___________________________________________________
Principal
Surety
Title of Official
Notary Public
Principal
Surety
Given under my hand and seal, this _______ day of ____________________, 20_____.
________________________________________________________________________
Signature of Notary Public
Seal
Surety Official Power of Attorney must be attached to this bond.
Dance Studio Declaration
The undersigned does hereby state and declare that he/she has been and is now the owner of:
_
_______________________________________________________________________________________________, dance studio,
Located at: ___________________________________________________________________________________________________.
That for the purposes of complying with Section 12 of the Dance Studio Act of the State of Illinois, he/she does hereby state and
declare that said dance studio gross income from the said dance studio’s business in the State of Illinois during the last fiscal year,
being from _________________________ to _________________________, was in the sum of __________________________,
I declare, under penalty of perjury, that the foregoing is true and correct.
Executed on __________ day of _____________________, 20______ at __________________________________________________
______________________________________________________.
Signed by: ____________________________________________________
Typed Name of Declarant: ________________________________________
Printed by authority of the State of Illinois. December 2009 50 I 222
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