Bail Bond Application

BAIL BOND APPLICATION AND INDEMNITY AGREEMENT

This Bail Bond Application and Indemnity Agreement (the "Agreement") is made as of Date: by and between Applicant Name: whose address is (the "Applicant"), and Surety Name: with principal place of business at (the "Surety").

RECITALS

WHEREAS, the Applicant seeks issuance by the Surety of a bail bond or undertaking to secure the appearance of Defendant/Principal before the court identified below; and

WHEREAS, the Surety requires execution of this Agreement, and the delivery of indemnity, collateral and other information as a condition precedent to the Surety's issuance of any bail bond; and

WHEREAS, the Applicant is willing to provide indemnity, collateral and assurances to the Surety in consideration for the Surety's issuance of the bail bond under the terms set forth herein.

NOW, THEREFORE, in consideration of the Surety issuing the bail bond and other mutual covenants, the parties agree as follows:

1. APPLICATION FOR BOND

2. BOND DETAILS

3. REPRESENTATIONS, WARRANTIES AND AUTHORIZATIONS

The Applicant represents and warrants to the Surety that all information provided in this Application is true, complete and correct. The Applicant authorizes the Surety and its agents to obtain and verify any and all information provided herein, including, without limitation, credit, employment, criminal history and motor vehicle records, and further authorizes any person or entity to release such information to the Surety.

4. INDEMNITY, SECURITY AND OBLIGATIONS

In consideration of the Surety issuing the requested bail bond, the Applicant (jointly and severally if more than one) agrees to indemnify, defend and hold harmless the Surety from and against any and all liability, loss, costs, counsel fees, expenses, and any other sums paid by the Surety in connection with the bond, including, without limitation, any forfeitures, penalties, court costs, and amounts paid to secure the surrender or return of the Principal. The Applicant grants the Surety a continuing security interest in any collateral described in this Agreement and authorizes the Surety to take possession, liquidate and apply the proceeds toward amounts owed without further notice, to the extent permitted by law.

5. CONDITIONS OF BOND; DUTIES UPON BAIL FORFEITURE

The Applicant acknowledges that the Principal must appear as required by the court and comply with all conditions of release. If the Principal fails to appear or otherwise breaches the conditions of the bond, the Applicant shall immediately surrender the Principal to the Surety or to the court upon demand, and the Applicant shall pay all sums due to the Surety, including any full forfeiture amount, within five (5) business days of demand. The Applicant acknowledges the Surety's right to undertake lawful measures, including engaging bounty hunters or law enforcement assistance where permitted by law, to locate and return the Principal, and agrees to reimburse the Surety for all associated costs.

6. PREMIUM, FEES, PAYMENT

Premiums and fees specified by the Surety are earned upon issuance of the bond and are non-refundable except as required by law or as otherwise expressly agreed in writing by the Surety. All amounts due hereunder are payable upon demand. If any amount is not paid when due, interest accrues at the maximum rate permitted by law and the Applicant will pay collection costs, including reasonable attorneys' fees.

7. NOTICES

Any notice required or permitted to be given under this Agreement shall be in writing and shall be deemed given when personally delivered or three (3) business days after deposit in the United States mail, postage prepaid, addressed to the parties at their addresses set forth in the opening paragraph or at such other address as a party may designate by written notice.

8. DEFAULT; REMEDIES

Upon the occurrence of any default by the Applicant, including failure to pay amounts due or failure of any representation to be true, the Surety may, at its option, declare all obligations of the Applicant immediately due and payable, take possession of any collateral, pursue any remedy available at law or in equity, and apply any proceeds to amounts owing. The Applicant shall be liable for and reimburse the Surety for all costs of collection and enforcement, including reasonable attorneys' fees, whether incurred before or after suit.

9. GOVERNING LAW; ENTIRE AGREEMENT; SEVERABILITY

This Agreement shall be governed by and construed in accordance with the laws of the State of without regard to conflict of laws principles. This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior agreements and understandings, whether written or oral. If any provision of this Agreement is determined to be invalid or unenforceable, that provision shall be modified to the minimum extent necessary to render it enforceable, or if incapable of modification, shall be severed, and the remainder of this Agreement shall remain in full force and effect.

10. AMENDMENT, WAIVER AND COUNTERPARTS

No amendment to this Agreement shall be effective unless in writing and signed by both parties. No failure or delay by either party in exercising any right shall operate as a waiver of that right. This Agreement may be executed in counterparts, each of which shall be deemed an original, and all of which together shall constitute one and the same instrument. Electronic or facsimile signatures shall have the same force and effect as original signatures.

11. ACKNOWLEDGMENTS

The Applicant acknowledges receipt of a true and complete copy of this Agreement and understands and agrees to be bound by its terms. The Applicant further acknowledges that any knowingly false statement made herein may subject the Applicant to criminal and civil penalties under applicable law.

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