Bail Application & Contract

1. Application Details

Agent

Date of Application

Offenses

Total Bond Amount

Total Prem.

Court

Appearance Date

Time

2. Defendant Information

Defendant's Full Name (First, Middle, Last)

Phone

Alias/Nickname/Street Name

Date of Birth

Place of Birth

Social Security No.

Height

Weight

Eye Color

Hair Color

Race

Scars/Tattoos/Marks, etc.

Address

Apt. #

Own Rent

Landlord

City, State/Zip Code

Previous Address

3. Occupation & Family Info

Present Occupation(s)

Previous Occupation(s)

Employer

Shift

How Long

Address (Employer)

Job Title

Phone (Employer)

Previous Employer

How Long

Union

Local #

Spouse Information

Spouse Full Name

Date of Birth

Social Security No.

Maiden Name

Occupation(s)

Employer

Shift

How Long

Address (Employer)

Job Title

Phone

Children Info

4. Auto & Additional Information

Auto Year

Make

Model

Color

Tag#

State

Amount Owed

Lien Holder

Insurance Agent/Company

Driver's License #

State

Expiration

Previous Arrests for

Where

On Probation/Parole?

Where

Officer

Credit Card Company 1

Account #

Credit Card Company 2

Account #

Attorney

Address

Phone

Relatives / Friends

Relation	Name	Address, City, State, Zip	Phone

5. Indemnitors (Co-Signers)

Up to 3 indemnitors can be added.

Indemnitor 1

Name

Employment

Employer

Address

City

Zip

Phone

Driver's Lic.

S.S. No.

D.O.B.

Relationship to defendant

Spouse

Reference (Personal or Credit) 1

Reference 2

Indemnitor 2

Name

Employment

Employer

Address

City

Zip

Phone

Driver's Lic.

S.S. No.

D.O.B.

Relationship to defendant

Spouse

Reference (Personal or Credit) 1

Reference 2

Indemnitor 3

Name

Employment

Employer

Address

City

Zip

Phone

Driver's Lic.

S.S. No.

D.O.B.

Relationship to defendant

Spouse

Reference (Personal or Credit) 1

Reference 2

6. Hold Harmless (Collateral/Vehicles)

Description of Collateral

VIN#

License Plate

I have read and had explained to me and understand the terms and conditions of 24/7 Bail Agency, Inc. executing the above listed Surety Bail Bonds on my behalf. I understand that I am assuming specific obligations and have read the Contract carefully. The premium paid on this bond is not returnable. I authorize 24/7 Bail Agency and/or production company to photograph me, take motion pictures, video footage, and/or make electronic sound recordings of me.

Electronic Signature (Type Full Name)

Bail Bond Application & Contract

Digital Bail Application

1. Application Details

2. Defendant Information

3. Occupation & Family Info

Spouse Information

4. Auto & Additional Information

5. Indemnitors (Co-Signers)

Indemnitor 1

Indemnitor 2

Indemnitor 3

6. Hold Harmless (Collateral/Vehicles)

Make 24/7 Bail Agency Your 1st Call For Bail

Application Submitted Successfully!