BAIL APPLICATION

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BAIL BOND UNDERWRITING APPLICATION & DEFENDANT) 
                                     CONTRACT 
 
  FIRST NAME                   MIDDLE NAME
 
   
                                           
 LAST NAME

BOND AMOUNT

NAME OF
 PARISH JAIL IS  IN

NAME OF JAIL

CITY,STATE, JAIL IS LOCATED IN WITH PHONE NUMBER IF KNOWN

RACE             D.O.B

PLACE OF BIRTH                                               HEIGHT,                       WEIGHT

MOBILE #                         ALIAS/NICKNAME/STREET NAME                   PAGER #

scars/ tattoos, marks, and others

ADDRESS:                                                           APT#                  APARTMENT #

PREVIOUS ADDRESS:

PRESENT OCCUPATION(S)

EMPLOYER:

SUPERVISOR NAME :

ADDRESS:

JOB TITLE:

HOW LONG ON JOB:

SPOUSE FULL NAME :

SPOUSE DATE OF BIRTH:

SPOUSE  SSN#

AGE            CHILD'S NAME/ ADDRESS   SCHOOL/ EMPLOYER

AUTO YEAR:                       MAKE:                      MODEL

COLOR:                           TAG:                       STATE :

AMOUNT OWED: $

LIEN  HOLDERS:

INSURANCE COMPANY:

INSURANCE AGENT:

DRIVER'S LICENSE #:

STATE:                              EXPIRATION DATE :

PROBATION /PAROLE ?

WHERE?

PROBATION/Probation OFFICER NAME:

RELATIVE/FRIENDS & ADDRESS, CITY, STATE,& ZIP ,PHONE 
     PLEASE LIST  10  ARE MORE.  SAME ADDRESS OR PHONE NUMBER IS COUNTED AS ONE, PLEASE INCLUDE FULL NAMES AREA CODES , CITY, STATES, AND ZIP CODES , AND THE RELATIONSHIP

BAIL BOND INDEMNITOR'S PROMISES 
----------------------------------------
DEFENDANT'S NAME :

INDEMNITOR'S NAME :

HOME ADDRESS:

COURT:

SS#

CITY:

STATE:

ZIip CODE:

HOME PHONE: (    )

EMPLOYER:

WORK ADDRESS:

WORK PHONE:

CITY:

STATE:

ZIP CODE:

DOB:

DL#

1. CONSIDERATION.  
THE CONSIDERATION OR CAUSE OF THIS AGREEMENT IS THE POSTING OF A BAIL BOND BY SURETY ON BEHALF OF DEFENDANT IN THE ABOVE NAMED COURT. 
2. INDEMNIFICATION.
 I, THE UNDERSIGNED HEREBY AGREE TO SAVE AND HOLD THE SURETY AND ITS AGENTS AND/ OR ASSIGNS FROM ANY LOSS WHATSOEVER RESULTING FROM THE FAILURE OF THE ABOVE NAMED DEFENDANT TO APPEAR IN COURT AS ORDERED. I THE UNDERSIGNED, HERBY AGREE T PAY ALL COSTS  ($500.00 MINIMUM CHARGES ) ASSOCIAATED WITH THE FAILURE OF THE ABOVE NAMED DEFENDANT TO APPEAR IN COURT AS ORDERED, IN U.S. CURRENCY TO SURETY, ITS AGENTS AND / OR  ASSIGNS UPON THE FAILURE OF THE ABOVE NAMED DEFENDDANT SHALL BE PRIMA FACIE EVIDENCE OF LOSS SUSTAINED BY SURETY AND ITS AGENTS AND/OR ASSIGNS.

3. JURISDICTION AND VENUE .
I, THE UNDERSIGNED HEREBY AGREE AND STIPULATE THAT ANY COURT OF PROPER JURISDICTION WHERE THE  BAIL BOND IS POSTED IS A CONVENIENT AND PROPER FORUM TO LITIGATE ANY DISPUTE UNDER THIS AGREEMENT.

4. ATTORNEYS FEES.
  I, THE UNDERSIGNED, HEREBY AGREE TO PAY ALL COURT COSTS AND ATTORNEYS FEES IN THE EVENT THIS MATTER IS TURNED OVER TO AN ATTORNEY FOR COLLECTION, WHICH ATTORNEYS FEE SHALL BE 33 1/3% OF THE SUBJECT MATTER OF THE LITIGATION.

5. AUTHORIZTION.
 I HERBY AUTHORIZE THE HOLDER OF THIS INSTRUMENT TO UTILIZE  ANY INFORMATION GIVEN ABOVE TO PURSUE THE COLLECTION OF ANY DEBT THAT MAY BE OWED.

6. SEVERABILITY.
 THE PROVISIONS OF THIS AGREEMENT ARE SEVERABLE AND IF FOR ANY REASON ANY PROVISION OF THIS AGREEMENT SHALL BE DECLARED INVALID OR UNENFOREABLE, THEN SUCH PROVISION OR PROVISIONS SHALL BE CONSIDERED AS NOT WRITTEN AND THE REMAINDER OF THIS AGREEMENT SHALL REMAIN VALID AND ENFORCEABLE.

INDEMNITOR'S SIGNATURE
__________________________

PROMISSORY NOTE

DATE_______________

$___________________

FOR VALUE RECEIVED, I THE UNDERSIGNED, UNCONDITIONALLY PROMISE TO PAY TO BEARER  ON DEMAND THE  AMOUNT OF______________
,  WITH INTEREST AFTER DEMAND IN THE AMOUNT  OF %12. THE MAKER OF THIS NOTE AND ENDORSERS GUARANTORS AND SURETIES HEREON, HEREBY SERVALLY WAIVE PRESENTMENT OF PAYMENT, NOTICE OF NON-PAYMENT, PROTEST, NOTICE OF PROTEST, CITATION AND SERVICE OF PETITION, ALL LEGAL DELAYS AND CONFESS JUDGMENT IN FAVOR OF ANY LEGAL HOLDER, AND ALL PLEAS OF DIVISION AND DISCUSSION, AND AGREE THAT THE TIME OF PAYMENT HEREOF MAY BE EXTENED  FROM TIME TO TIME, ONE OR MORE TIMES, WITHOUT, NOTICE OF EXTENSION OR EXTENSIIONS AND WITHOUT PREVIOUS CONSENT HEREBY BINDING THEMSELVES IN SOLIDO, UNCONDITIONALLY, AND AS ORGINAL PROMISSORS, FOR THE PAYMENT THEROF IN PRINCIPAL, INTEREST, COSTS AND ATTORNEY FEES. NO DELAY ON THE PART OF THE HOLDER HEREOF AND EXERCISING ANY RIGHTS HEREUNDER SHALL OPERATE AS A WAIVER OF SUCH RIGHTS.

SHOULD THIS NOT NOT BE PAID AT MATURITY OR WHEN DUE OR DEMANDABLE, AS HERIN PROVIDED, OR SHOULD THIS NOTE BE PLACED IN THE HANDS OF AN ATTORNEY FOR ANY REASON THE MAKERS, ENDORSERS, GUARANTORS AND SURETIES AND EACH OF THEM HEREBY AGREE TO PAY THE FEES OF SUCH ATTORNEY, WHICH  ARE HEREBY FIXED AT 
331/3% ON THE AMOUNT DUE ON THE NOTE TOGETHER WITH INTEREST AND ALL COSTS (500.00 MINIUM CHARGE)

A MARRRIED PERSON SIGNING THIS NOTE IS ACTING FOR AND ON BEHALF OF THE COMMUNITY OF ACQUETS AND GAINS EXISTING BETWEEN HIM/HER AND HIS/HER HUSBAND/WIFE AND ALSO BINDS HIM/HER WITH RESPECT TO HIS/HER SEPARATE AND PARAPHERNAL PROPERTY.

THE PROVISIONS OF THIS NOTE ARE SEVERABLE AND IF FOR ANY REASON ANY PROVISION OF THIS NOTE SHALL BE DECLARED INVALID OR UNENFORCEABLE, THEN SUCH PROVISION OR PROVISIONS SHALL BE CONSIDERED AS NOT WRITTEN AND THE REMAINDER  OF THIS NOTE SHALL REMAIN VALID AND ENFORCEABLE.

BY SIGNING THIS DOCUMENT/AGREEMENT/CONTRACT  I UNDERSTAND  AND AGREE TO ALL OF THE ABOVE  IM SIGNING OVER 
OVER THE INTERNET THE SAME IF I WAS SIGNING IN PURPOSE BY 
TYPING IN MY NAME AND PERSONAL INFROMATION .

indemnitor's signature

IN THE BLANK SPACE  BELOW PLEASE PLEASE EXPLAN  YOUR RELATIONSHIP TO THIS DEFENDENT WHY ARE YOU SIGNING THIS AGREEMENT TO BOND HIM OR HER OUT OF JAIL AND HOW ARE YOU GOING TO BENIFIT FROM SIGNING THIS CONTRACT, AND EXPLAIN IN YOUR OWN WORDS  ON WHAT IS A BAIL  BOND , AND YOUR DUTIES FROM SIGNING THIS CONTRACT,  AND WHAT  WILL  HAPPEN  TO  THE INDEMNITOR'S  IF  THE DEFENDENT DO NOT SHOW UP FOR COURT. PLEASE  TELL  US SOMETHING PERSON ABOUT YOU AND THE DEFENDENDANT  TO PROVE  A  ACCPECTABLE  RELATIONSHIP