Fill and Sign the Municipal Courtcortez Co Official Website City of Cortez Form

JDF 370 R07/19 Appearance Bond (1) Court (2) Defendant (3) Jail (4) Surety Page 1 of 2 ❑ Municipal Court ❑ County Court ❑ District Court ____________________________________ County, Colorado Court Address: v. COURT USE ONLY Case Number: Arrest Number: Warrant Number: Division Courtroom APPEARANCE BOND Bond Type: ❑ Bail Bonding Agent * ❑ Cash/Self** ❑ Cash/Surety *** ❑ PR/Self ❑ PR/Surety ❑ Property Bond Posted For: ❑ Defendant ❑ Respondent ❑ Plaintiff ❑ Petitioner ❑ Child Name of Party (print or type): __________________________________________ Date of Birth : ___________ First Middle Last The Party, as principal, and (print or type): ________________________________________________________, as surety, acknowledge that we are jointly and severally bound to the People of the State of Colorado, in the penal sum of ___________________________________________________($_________________) DOLLARS, if there is a default upon the primary condition of this Bond. The bail agent charged a premium in the amount of $_______________. The primary condition of this Bond is that the Party shall personally appear in the (Court name and address): _________________________________________________________________________, on ____________________________ (return date), at _____________ (time) and at each place, and upon each date, to which this proceeding is transferred or continued, until entry of an order for deferred prosecution or deferred judgment, plea of guilty, nolo c ontendere or conviction ; ❑ I agree to a continuance of this bond through sentencing ; to answer charges of: NOTE: If the return date and time is a legal holiday or a weekend, the return date is a mandatory appearance on the first business day thereafter . Additional Conditions: (1) Party shall not commit a felony while at liberty on bail; (2) Party shall immediately notify the Court of any change of mailing address or residence. ❑ Pursuant to §16 -3-503, C.R.S. you shall execute a waiver that states you understand that the bond or fees shall be forfeited if the Defendant is removed from the country. ❑ If you have been arrested for a Felony offense, you shall sign a written waiver of extradition indicating you waive all formal proceedings in the event you are arrested in another state and you agree to be returned to Colorado. ❑ Party may not leave the state; ❑ Party acknowledges the existence of a Mandatory Protection order under §18 - 1-1001, C.R.S.; ❑ No Weapons ❑ No Alcohol ❑ No Drugs ❑ No Driving W ithout a Valid License ❑ Random UA’s ❑ Random BA’s ❑ Daily BA’s ❑ GPS Monitoring ❑ Substance Abuse Monitoring ❑ Electronic Substance Abuse Monitoring ❑ Electronic Home Monitoring ❑ Other ❑ Pre -trial Supervision _______________________________ (contact informatio n) ❑ Other_____________ ❑ No Contact with ❑ Other JDF 370 R07/19 Appearance Bond (1) Court (2) Defendant (3) Jail (4) Surety Page 2 of 2 Defendant’s Name (Printed): ____________________________________ Case Number: ________________________________________________ If the Party fails to comply with any of the conditions of this Bond, the Court may revoke the Party’s release on bail, increase the amount of bail or modify bond conditions. This Bond will be forfeited if the party does not appear in Court as required by the primary bond condition. You are not req uired to agree to apply the cash bond deposited in this case toward any amount owed as a condition of release. Use of the deposit for such purpose may only occur if you voluntarily agree in writing to such use. Please choose one of the following: ❑ I cons ent and authorize the court to apply the cash bond deposited in this case to any and all court costs, restitution, fines, fees and surcharges owed by me at the time I am discharged from all liability under the terms of the bond . Any funds remaining must b e returned to me as defendant at the address provided below . ❑ I do not consent or authorize the court to apply the cash bond deposited in this case to ward any amount owed by me. __________________________________________________________________________________________ Party Signature Address (Street, City, State, & Zip Code) Telephone Number ________________________________________________________ _______ ___________________________ Surety/Bonding Agent * /Bonding Commissioner/Judge Signature __________________________________________________________________________________________ Address (Street, City, State, & Zip Code) Telephone Number Bonding Agent License No : _________________ ____ __ Power of Attorney No.: _______ __ ______________ __________________________________________________________________________________________ Surety Other than Bonding Agent ** Signature Address (Street, City, State, & Zip Code) Telephone Number * Bonding Agent Certification: Agent, by e xecuting this Bond, warrants and represents to the Court, under oath, and under penalty of perjury: (1) that agent is not currently in default in payment of any final judgment upon any bail bond forfeited in any Colorado jurisdiction; (2) that agent is dul y licensed by the State of Colorado to execute this Bond; (3) that agent, if a non -cash agent, is currently appointed by the corporate surety whose power of attorney accompanies this Bond. Executed and Acknowledged by the above named in the presence of the undersigned at: _____________________________________________________________________________ (name of court or facility where bond written). By: ______________________ _____ _______________By: __________________________________________ Deputy Clerk/Sheriff (As to Surety/Bonding Agent) Deputy Clerk/Sheriff (As to Defendant) Date: ______ ____ _______ ____ ___ Time: _______ __ __Date: ________________ _______ Time: __ __ ________