Fill and Sign the Defendant as Principal and the Sureties Other People Responsible for the Bond Do Jointly Form

Exempt From VRA Certif. Page 1 of 2 CR -240 (1/19)( cs) AS 12.30.006-.080 SURETY BOND Civil R. 80, Crim. R. 41 IN THE DISTRICT/SUPERIOR COURT FOR THE STATE OF ALASKA AT STATE OF ALASKA ) ) Plaintiff, ) ) vs. ) ) ) CASE NO. CR Defendant. ) DOB ) SURETY BOND APSIN: ATN: DL/ID: ST: Comm. Lic. The defendant as principal, and the sureties (other people responsible for the bond), do jointly and severally acknowledge that we and our personal representatives are bound to pay to the State of Alaska $ . We understand and agree that: 1. The bonds continue until the court cancels them. 2. If the defendant complies with the conditions of the bonds, the bonds will be canceled. 3. If the defendant fails to comply with the conditions of the bonds, the court may enter a judgment against the defendant and the sureties for the amount of the bond, plus costs and interest. A writ of execution may be issued against our property to satisfy the judgment. 4. It is our responsibility to notify the court of any changes to email or mailing address . (Use court form TF-955. ) Defendant’s Signature Print Name Date Mailing Address City State ZIP Home Phone Work Phone Cell Phone Email* *By providing my email address, I request that the court email court documents issued in this case to the email address provided above. I agree to notify the court if I change my email address or wish to receive documents by mail by using form TF-820 , Electronic Delivery of Case Documents. Date Name of Surety 1* Signature of Surety 1 Date Name of Surety 2* Signature of Surety 2 * A "Surety Agreement and Affidavit" (see next page) must be attached for each surety. ACKNOWLEDGMENT On , 20 , the defendant and the sureties named above personally appeared before me in , Alaska and acknowledged to me that they signed the above agreement freely and voluntarily for the purposes stated therein. (SEAL) Clerk of Court, Notary Public or other person authorized to administer oaths My commission expires: SURETY BOND, Page 2 of 2 Defendant's Name Case No. Page 2 of 2 CR -240 (1/19)( cs) AS 12.30.006 -.080 SURETY BOND Civil R. 80, Crim. R. 41 SURETY AGREEMENT AND AFFIDAVIT I, , swear under oath that: 1. I am a resident of Alaska. 2. I am worth the amount of the bond specified above, $ , exclusive of property exempt from execution, and exceeding all my just debts and liabilities. a. My assets, any outstanding liens and exemptions are as follows: Value Outstanding Liens Applicable Exemptions (AS 9.38) Cash Auto/Truck Business Stocks/Bonds Real Property TOTAL b. I understand my right to exemptions from execution under AS 9.38 and have determined that I am entitled to no exemptions other than those listed in the third column above. [ See Judgment Debtor's Booklet ( CIV-511 ) for description of exemptions. ] c. I have the following outstanding judgments, lawsuits and other possible claims pending against me or any partnership or unincorporated association of which I am a member: d. I agree not to sell, mortgage, encumber, or in any manner whatsoever, convey my interest in the property listed above without written permission of the Court. 3. I am not an attorney at law, peace officer, clerk of any court, or other officer of any court. I understand that if the defendant in this case fails to comply with the conditions of the bond set forth above, the court may order the bond due immediately and enter a judgment against me as surety for the amount of the bond plus costs and interest as allowed by law. Surety Signature Type or Print Name Date of Birth Phone Mailing Address Email* City State ZIP *By providing my email address, I request that the court email court documents issued in this case to the email address provided above. I agree to notify the court if I change my email address or wish to receive documents by mail by using form TF-820 , Electronic Delivery of Case Documents. Subscribed and sworn to or affirmed before me at , Alaska on , 20 . (SEAL) Notary Public/Judge/Clerk of Court My commission expires: I examined the foregoing surety bond and recommend it for approval as provided in Civ . R. 80. Date Defense Attorney The surety bond is approved. Date District Attorney Date Judge