Fill and Sign the Certificate of Professional Bondsman Professional Forms

State of Alabam a Unified Judicial System Form CR-1 3 Rev .4/99 CERTIFICATE OF PROFESSIONAL BONDSMAN (Professional Bail Company) Da te Filed STAT E OF AL AB AM A IN THE CIRCUIT COURT OF ___________________________________________________________________ COUN\ TY TO THE CIRCUIT COURT CLERK I, _______________________________________________, ON BEHA LF OF ____________________________________ ________________________________________________ (nam e of professional bail com pany), REQUEST THA T THE COMPA NY BE AUTHORIZED TO EXECUTE BONDS IN ITS NA ME A S SURETY RETURNA BLE TO THE CIRCUIT, DISTRICT A ND MUNICIPA L COURTS OF TH IS COUNTY, A ND DO CERTIFY THA T: 1. I am a resident of the State of Alabama, residing at: ________________________________________________________________________\ ___________________________________ (address) (city) (county) The company is duly authorized to do business in the State of Alabam a, and has its principal of business w ithin the State of Alabama at follow ing address: ________________________________________________________________________\ ___________________________________ (address) (city) (county) Its resident agent for service of pr ocess is: ____________________________________________________, w hose address is ________________________________________________________________________\ ___________________________________ (address) (city) (county) 2. I am a/the ____________________ of the above-named company w hich is a ________________________________________ organized under the law s of the State of __________________, and I am duly authorized to execute this certificate on its behalf . 3. The company has not violated any provisi ons of the Alabama Rules of Criminal Proc edure or orders of court w ithin the past tw o (2) years. 4. The only persons w ho have any financial inte rests, either direct or indirect, in the professional bail company are as follow s: Name Address Nature and Extent of interest ________________________________ _________________________________\ _______ _____________________________ ________________________________ _________________________________\ _______ _____________________________ ________________________________ _________________________________\ _______ _____________________________ ________________________________ _________________________________\ _______ _____________________________ ________________________________ _________________________________\ _______ _____________________________ ________________________________ _________________________________\ _______ _____________________________ 5. None of the above-named persons has been c onvicted of a felony or a crime involving moral turpitude except the follow ing per sons: ________________________________________________________________________\ ____________________________________ ________________________________________________________________________\ ____________________________________ ________________________________________________________________________\ ____________________________________ who have been convicted of the follow ing offenses: ___________________________________________________________ and who have been pardoned or have had a restoration of civil rights. 6. The company has a sufficient financial net w orth to satisfy the obligations w hich it may enter into as a surety , taking into consideration all other outstanding obligations and liabilities. 7. All appearance bonds shall be executed in the name of ________________________________________________________________________\ ____________________________________ (nam e of professional bail com pany) as surety by the agents listed or appointed in the Qualify ing Pow er of Attorney s, letter, or other documents presented to the c ourt or any other so named in any such future Qualify ing Pow er of Atto rney , letter or other documents presented to the court or filed with the circuit clerk of the county . ________________________________________________________________________\ ____________________________________ (nam e of professional bail com pany) has no know ledge of any final forfeiture s issued against it, w hich has been made fo r more than thirty day s and of which ________________________________________________________________________\ ______________________ has no petitions, motions or other ty pe litigation pending, that have not been paid, arising out of surety undertakings. * This certificate must be executed by an ow ner or officer of a professional bail company . Form CR-13 (back) Rev.4/99 CERTIFICATE OF PROFESSIONAL BONDSMAN (Professional Bail Company) 9. That there are no persons, including employees, agents or persons with a financial interest in _______________________________________________________________________\ _____________________________________ (name of professional bail company) who have within a period of two (2) years, violated any prov isions of the Bail Bond Reform Act, rules adopted by the Supreme Court governing the qualifications of professional surety or bail companies or any c ourt order pertaining to the provisions of these rules 10. No employee, agent nor any other person having a direct or any indirect financial interest in ________________________________________________________________________\ ____________________________________ (name of professional bail company) is an attorney, a judicial official, a person authorized to accept an appearance bond, or an agent of an attorney or judicial official. 11. Should the Qualifying Power of Attorney for the named agent s be terminated or the license of such agent or underwriters be revoked, suspended or cancelled, the affiant herein agrees to promptly notify the court of such action, and the agent’s authority to execute appearance bonds shall be withdrawn until otherwise qualified pursuant to Rule 7, Ala.R.Crim.P. or the Bail Bond Reform Act. I HAVE NOTICE THAT FALSE STATEMENTS ARE PUNISHABLE AS PERJURY AND CERTIFY THAT THE ABOVE STATEMENTS ARE TRUE AND CORRECT. Sworn to and subscribed before me this ________________________________________________________ Affiant’s Signature ____________________________________ date ________________________________________________________ Social Security Number ____________________________________ Clerk of the Circuit Court _______________________________________________\ _________ Telephone Number IF THIS REQUEST FOR AUTHORIZATION TO BE A PROFESSIONAL BONDSMAN IS GRANTED, IT IS UNDERSTOOD: 1. that the court at any time on its own motion may, or on ve rified motion of the district attorney shall, subpoena for examina tion under oath any officer, agent, or person having a financial intere st in the applicant or other persons, and all relevant books records, tax returns, and financial data, concerning matters relating to the foregoing certificates; 2. that authorization to act as a professional bondsman may be revoked or withheld by the court fo r violation of any provision of the bail Bond Reform Act or Rule 7, Ala.R.Crim.P., for supplying false or inaccurate information contained in the foregoing certificate for failure to submit subpoenaed documents, or for failu re of any of applicant’s officers or agents, or any other person having any financial interest, direct or indirect, in applicant’s bail bond business to answer truthfully all relevant questions asked by the court or the district attorney’ and 3. that authorization to act as a profe ssional bondsman pursuant to this certificate must be authorized by order of the presiding circuit judge and shall be valid for only one year from the date of approval , and further that a completed certificate must be filed with the circuit court clerk and approved by the presiding circuit judge each year. Attached hereto is a validated copy of a corporate surety bond in the amount of $25,000 in the county, guaranteeing the payment of all sums of money, up to the limits of the bond, that may beco me due by virtue of any judgment absolute being rendered against the applicant company on a forfeiture. The bond may be cancelled as to any future liability only by the surety giving thirty (3 0) days notice in writing to the clerk of this court prior to cancellation. _______________________________________________________ Applicant’s Signature _______________________________________________________ Date _______________________________________________________ Social Security Number _______________________________________________________ Telephone Number