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<br />I _________
<br />==f;=:-~2~INDEMNITY BOND FOR LOST INSTRUMENT. (Sec. 21.06.03. .12~~;~~~-:~ D, C. C.) -
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<br />INDEMNITY BOND ON LOST INSTRUMENT
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<br />Whereas,.............,.~~--d-or.iu...~....1f-.'1t--...r:d..~__.............hereinafter designated as claiman t, :!
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<br />claims to b~the owne and entitled to the payment oVa certain.....~~..~.~.Q.33.t ~.m...m......on..........__... Ii
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<br />dated.... ....... .........1t~.. .....212a.5..............m.......,.......due.......... ~..... . .... ...J~..fl.()D~........__.........on....__......... Ii
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<br />pa yablo t -.......--J'5:..i . .~....C!\..:-i-....r~..k2-"'>.IMt.L...._...__....:..............._._..............-:.;..........-...-.. I,
<br />for th e su m of.. (.~.....~2.l.....r::1~......_... ...........~.=.......on........ .............m..................................on.........:::1:>olla rs, i:
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<br />execu ted by............................................................~..~........ ........ ...... __...................... ....................... ....... on'" ................. Ii
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<br />but is unable to produce or surrender said instrument upon sueR payment on account of its loss, destruction, or Ii
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<br />otherwise. Ii
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<br />do.;g~~:' a:~~~~~~~~a::;~~~~:.;:-~::.~:~~::;:.:;.:;~~~:.;~:-~=:~:;.~.~:;~~:~-~;.~;:~;;:;:~~: II
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<br />thereof, we, the undersigned, do jointly and severally promise, undertake and agree to and with said obligee, his or il
<br />its successors, heirs, administrators and assigns, that we will save said obligee, his or its successors, heirs, administra- i,l'
<br />tors and assigns, harmless from any and all claims of any person or persons in and to said instrument, or to the pay-
<br />ment thereof, in whole or in part, and from any and all damages, remote or proximate, sustained by virtue of said 'i
<br />payment, including all attorney's fees, costs, expenses, charges) or liabilities assumed, incurred or expended, and will I
<br />at any time up.ondemand payor cause to be paid to said obligee, in addition thereto, the amount so paid to said
<br />claimant by said obligee with accrued interest thereon from the date of such payment at the rate of............per cent
<br />per annum and undertake and perform any and all steps, actions or proceedings which said obligee may deem necessary
<br />or requisite to save said obligee harmless from further liability, cost, expense or damage in the premises.
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<br />'i-." Da t,d thi,.m......._....J5~.__.._..._......._.....day Or....._b~fo.:~;C..,..._..................l-... .11...1
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<br />. ..........00...... .m...... ............ '.m ...... ............... ................ ................. ... ...... .................... m...... ............. .............. ......... .......00... (S EAL)
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<br />On this..mn.........m...Lt!.....?:.......m.................day oL............J~m..................__.....in the year~1, before me,
<br />person ally a ppeared..........L1tf~.. ...nc(~"'........c.C~~f1:.......... ....... ............ .......m..............:.....m.. .....00...... .............000......
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<br />an d.....~.................. On... ....... ...... ...... ........ .... ........... ............. .......................... 00......................00.................... .............m. ........ ..............
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<br />known to me to be the persons who are described in and who executed the within instrument, and, who, each for
<br />himself, personally acknowledged to me that they executed the same.
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<br />J D THOMPSON
<br />I Notary Public
<br />My commission l~ xp.ires...S.toJ~..Q.f.J:.l.9.~tJ:U~.O.~Qtgm..........
<br />lV1y Commission Expires Fee. 10, 2012
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<br />STATE OF NORTH DAKOTA )
<br />County of......................m.................n...... ss.
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<br />and........m.m.............m...........m............m..m...........m........m....m....... being first duly sworn, upon oath, each for himself
<br />doth say: The he is one of the sureties on, and who executed the within and foregoing bond. That he is a freeholder of
<br />the State of North Dakota and a resident of the said County oL............................................m........n....., North Dakota.
<br />Tha the is worth th e sum of... .......m.......................... .......--......... ............................. ....... ............ ..... ..:............... .....000.... Doll ars
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