Fill and Sign the Recognizance Form

IN THE ___________ COURT OF _____________ (County), ______________ (State) ____________________ PLAINTIFF (Name of State) V. CAUSE NO. ____________ ____________________ DEFENDANT (Name of Defendant) Agreement to Appear I declare under the penalty of perjury that, pursuant to the provisions of (citation of statute) ____________________, I agree to the following conditions: 1. I will appear on _____________________ (date of appearance) , at the above- designated Department of the ____________________ (name of court) of _________________ (name of state) , located at ______________________________ _____________________________________________ (address of courthouse) , ___________________ (name of city) , ________________ (name of county) , ___________________ (name of state) , and at all times and in whatever court in which the above matter may be scheduled. 2. If I fail to so appear and am apprehended outside _______________ (name of state) , I waive extradition. 3. Any court of competent jurisdiction may revoke the order of release and either return me to custody or require that I give bail or other assurance of my appearance as elsewhere provided by (citation of statute) ___________________________. Executed on _________________ (date of execution) , at _________________ (name of city) , __________________ (name of state) . ________________________ (Printed Name of Defendant) ________________________ (Signature of Defendant) ________________________ (Address of Defendant) ________________________ (Phone No. of Defendant)