of a Negotiable Instrument
---------- COURT OF THE STATE OF ----------
COUNTY OF ----------
WHEREAS, one Principal of this Bond is Plaintiff in the above-entitled action to recover against Defendant the sum of ---------- dollars ($----------), which is the principal sum and accrued interest of a check [or, note, draft], of [date], held by Plaintiff and on which Defendant is obligated as Drawer [or, Drawee, Maker]; and
WHEREAS, Plaintiff has sworn to the Court that the instrument cannot be presented because it has been lost [or, stolen, destroyed), and Plaintiff has established before the Court the terms and conditions of the instrument, Plaintiff's ownership thereof, and the reasons preventing the production of the instrument in Court.
THEREFORE, [Plaintiff], as Principal, and [name], as Surety, whose principal place of business is located at [address] (collectively called Obligor), are hereby firmly bound to the following parties to the instrument: [name] and [name] (collectively called Obligee), in a sum sufficient to indemnify Obligee under the conditions of this Bond, not to exceed the sum of ---------- dollars ($----------) in the case of the Surety.
The conditions of this Bond are:
1. Obligor shall deliver the instrument to Obligee for cancellation should it come into the hands or control of Obligee.
2. Obligor shall indemnify and hold Obligee harmless from all other claims and actions based upon the instrument and from all liabilities, damages, expenses, and counsel fees resulting from such claims or actions.
Agreed to this [dated].
This Bond is accepted this