No. ..........................

Amount $.................................................…….....

KNOW ALL THESE MEN BY THESE PRESENTS: that we,.........................................................................
of.......................................................................... in the Province........................................................................................
hereinafter called the “Principal”, and................................................................................................hereinafter called the “Surety”, are jointly and severally bound unto Her Majesty in right of Canada, her heirs and successors, as represented by the Minister of National Revenue of Canada, hereinafter called the “Obligee”, in the penal sum of ...................... Dollars ($...............) of the lawful money of Canada to be paid to the said Obligee, for which payment well and faithfully to be made we jointly and severally bind ourselves and our respective heirs, executors, administrators, successors and assigns firmly by these presents, sealed with our respective seals and dated the .................... day of ................................. in the year of Our Lord ............................................................................................................ .

WHEREAS the Principal has applied to the Superior Officer of Excise Duty for ............................................ (see note 1 below) in Canada for a license agreeable to the provisions of the Excise Act, being chapter E-14 of the Revised Statues of Canada 1985, as amended, under which license when granted he will be charged with all responsibilities and will enjoy all the privileges and immunities which are by the said Act imposed or conferred upon a licensed............................................................ (see note 2 below).

NOW the condition of the above written obligation is such that if, upon the granting of such license, the Principal or his heirs, executors, administrators, successors or assigns shall duly render all accounts, inventories, statements and returns prescribed by law and pay all duties of excise, interest and penalties which he is or may become liable to pay under the provisions of the Excise Act and of any other Act of Parliament in respect of the imposition, levy and collection of duties of excise and shall well, truly and faithfully comply with all the enactments and requirements of the said Act or any other Act of Parliament as aforesaid and of any Order in Council, departmental or other regulation made by competent authority according to their true intent and meaning as well with regard to such accounts, inventories, statements, returns, duties of excise, interest and penalties as to all other matters and things whatsoever, then this obligation shall be void and of no effect but otherwise shall be and remain in full force, virtue and effect. Notwithstanding the foregoing, it is understood and agreed that the liability of the Surety hereunder shall be limited to the amount stated herein and shall not be cumulative from year to year during the existence of this bond.

PROVIDED that if the Surety shall at any time give sixty days prior written notice to the above said Superior Officer of Excise Duty of its intention to terminate the obligation hereby undertaken, then this obligation and all liability of the Surety hereunder shall cease and determine so far as concerns any act or dealing on the part of the Principal subsequent to the termination of the obligation hereby undertaken but otherwise shall remain in full force, virtue and effect in respect of any act or dealing on the part of the Principal from the date of such termination. Notice of any claim hereunder shall be given to the Surety within one year following the date of termination as herein provided.

IN WITNESS WHEREOF the Principal has hereunto set his hand and seal and the Surety has caused these presents to be sealed with its corporate seal, attested to by the signatures of its duly authorized officials the day and year first above written.

Signed, sealed and delivered in the presence of

Witness:

Seal:

Principal:

Seal:

Surety:

Authorized Official or:

Officials:

Note 1: Insert the appropriate regional excise duty office location.
Note 2: Insert brewer and/or wort manufacturer.