I, (name as appears on card) * , authorize A-1 Bonding Company of Knoxville to charge my MasterCard, Visa, Discover, American Express, or Bank Check Card listed below
Card 1 # *
EXP Date *
CVC *
Amt: * $
Credit Card Authorization # Card 1
Card 2 #
EXP Date
CVC
Amt: $
Credit Card Authorization # Card 2
Card 3 #
Credit Card Authorization # Card 3
And a refundable collateral deposit in the amount of $ (Collateral will be returned in full less 3% credit card processing fee, if paid or returned by credit card upon final disposition of the case)
For a Bail Bond executed: *
MR/MRS/MS (Defendant) *
I, (name as appears on card) * , understand and acknowledge that by signing below I am agreeing to indemnify and hold harmless A-1 Bonding Company of Knoxville for any and all charge backs and/or dishonored charges that may occur from the above Credit Card transaction. I further agree to reimburse A-1 Bonding Company of Knoxville for any and all legal and/or collection fees that may be incurred as a result of such charge backs and/or dishonored charges.
Signed on this day: *
Signature * Clear
Printed Name of Card Holder as it Appears on Card *
Billing Address*
RE:
Date:
Name * Address *
City *
State: *
ZIP: *
Own *Rent *
Years at address: *
Previous address (if less than 5 years):
Home Phone:
Cell Phone:
Date of Birth: *
SSN: *
Employer:
Address:
How Long:
Employer Phone:
Spouse/ex-spouse/girlfriend/boyfriend:
City/State/ZIP:
Parents: Name, Address & Phone
1. 2.
Brother/Sister: Name, Address & Phone
1. 2. 3.
References (other then family members): Name, Address & Phone
1. You have a responsibility as a co-signer to make sure that the person you are co-signing for reports to court when He/She is scheduled, if they fail to do so, you will be responsible for the full amount of the bond in the event that the defendant cannot be located and the bond forfeiture becomes final with the court. 2. If we extended credit to the defendant at the time the bond was posted, you are responsible for making sure payments are made each month either by the defendant or yourself. 3. Credit is given as a courtesy to our clients. In the event the case is dismissed any remaining balance is still due. As a Co-Signer, this is also your responsibility. 4. In consideration of A-1 BONDING Company making the bond of (principal) the following makers and endorsers, (principal) and (co-principal) , do hereby promise to A-1 BONDING COMPANY together with any other assignees or other holder, at the office of the holder, the sum of $$ ,(Amount Written out) . This note shall be due on demand upon a final forfeiture of the bond of (principal) Upon default in the payment of this note the makers and endorsers agree to pay all costs of collection including reasonable attorney's fees of 25% in case this note is collected by or though an attorney at law plus and all expenses incurred as a result of the final bond forfeiture and those expenses incurred in seeking and/or apprehending the principal. The liability of the undersigned is joint and several and this indebtedness may be enforced against anyone or more of the undersigned. I have read and do fully understand the terms and contents of this note.
Defendant: * Signature * Clear Print * SSN: * Date of Birth: *
Name of Agent:
Name
Alias/Nickname
Address
Apt.Lot #
City/State/Zip:
Length of Residence:
Phone No:
Cell Phone No:
Pager No:
SSN:
Date of Birth:
Age:
Race:
Sex:
Hgt.:
Wgt.:
Eyes:
Hair:
Scars/Tattoos:
OLN/ID #:
Auto:
Employer/Occupation:
Work Phone No.:
Charge
Warrant No.
Court
Bond Amount
Spouse or Girl/Boyfriend
Children (name, age, phone no.)
Name:
1.
2.
3.
Phone:
4.
Employer/Phone:
5.
Father
Mother
name:
References
Name/Address/Phone Name/Address/Phone Name/Address/Phone Name/Address/Phone
Contact Person:
Phone No.:
Pending Probation/Parole YesNo
If Yes, Officer:
Previous Arrest:
County:
Court Pending:
A. NOW THEREFORE, in consideration of the execution by the Company of such bond or undertaking, the Principal(s) covenant(s) and agree(S) with The Company as follows:
B. The Principal(s) will pay to the Company or its duly authorized agent, the premium(s) specified in said application at the times and in the amounts therein stated.
C. The Principal(s) agree that the Company may at any time take such steps it may deem necessary to obtain its release from any and all liability under any of said bonds or undertakings, and it shall not be necessary for the Company to give the Principal(s) notice of any fact or information coming to the Company's notice or knowledge concerning or affecting its rights or liability under any such bond or undertaking. notice of all such bond or undertaking, notice of all such being hereby expressly waived: and that the Company may secure and further indemnify itself against loss, damages and/or expenses in connection with any such bond or undertaking in any manner it may think proper including surrender of the defendant (either before or after forfeiture and/or payment) if the Company shall deem the same advisable: and all expenses which the Company may sustain or incur or be put to in obtaining such release or in further securing itself against loss, shall be borne and paid by the Principal(s)
D. This instrument shall be binding at all times and not void for any reason.
E. The Principal(s) hereby warrant(s) that the foregoing declarations made and answers given are the truth without reservation and are made for the purpose of inducing the company to execute Bond.
F. The principal and co-principal shall sign this agreement for A-1 BONDING COMPANY to have access to All Criminal Histories past and present. That the principal and co-principal will grant A-1 BONDING COMPANY access to all credit reports and credit histories.
G. The acceptance of this Agreement and of the Principal(s) agreement to pay premiums on the execution and on continuance of said bond(s) or undertaking(s), and/or the acceptance of any time by the Company of other collateral security or agreement, shall not in any way abridge or limit the right of the Company to be subrogated to any right or remedy, or limit any right or remedy which the Company may otherwise have, acquire, exercise or enforce under this or any other agreement or by law allowed, and the Company shall have every right and remedy which an individual surety acting without compensation would have: all such rights being construed to be cumulative and for the sole benefit of the Company, its successors and/or assigns.
H. The co-principal will assume full responsibility for the the bond fee should the principal fail to pay. The co-principal will also be subject to same recourse and attorney fees as spelled out for principal should A-1 BONDING COMPANY seek remedy to collect their fees.
I. In making application for the hereinabove described Bail Bond we warrant all of the statements made on the reverse of this instrument to be true and we agree to advise the Surety its agent of any change (especially change of address) within 48 hours after such change has occurred and agree that any failure to so notify shall be cause for the immediate surrender of the defendant without any liability for the return of any part of the premium. 1. A-1 BONDING COMPANY, as bail, shall have control and jurisdiction over the principal during the term for which the bond is executed and shall have the right to apprehend, arrest and surrender the principal to the proper officials at any time as provided by law. The principal hereby waves all right to extradition should he or she leave the State of Tennessee. 2. It is understood and agreed that the happening of any of the following events shall constitute a breach of principal's obligations to the A-1 BONDING COMPANY: (a) If principal shall depart the jurisdiction of the court without the consent of A-1 BONDING COMPANY. (b) If principal shall1 move from one address to another without notifying A-1 BONDING COMPANY. (c) If principal shall commit any act which shall constitute reasonable evidence of principal's intention to cause a forfeiture of said bond. (d) If principal shall make any material false statement in the application. (e) If principal shall be incarcerated while under the bond. (f) Signature of principal is evidence of his agreement that monies paid by him concerning this bond is irrevocable. (g) That principal and co-principal have read this contract and note and agree to all terms of it. 3. The principal and co-principal each hereby authorizes A-1 BONDING COMPANY, bearing this release, or any copy thereof, to obtain any information from any physician, psychiatrist, psychologist, hospital, clinic, or any other medical institution, from any local, state or federal governmental body including but not limited to the Dept. of Human Services, the Social Security Administration, the U.S. Postal Service, and also any public utility including telephone records, local and long distance carriers, power and or electrical companies. The principal and co-principal also authorizes the release of any information from any employer, banking or credit company, credit bureau, lending agency, consumer reporting agency, retail establishments or other governmental or private agency, agency, including including it's officers, employees, or related personnel both individually and collectively, from any and all liabilities resulting from compliance or attempts to comply with this authorization and request to release information.
In consideration of A-1 BONDING COMPANY making the bond of (principal) the following makers and endorsers, (principal) and (co-principal), do hereby promise to A-1 BONDING COMPANY together with any other assignees hereof or other holder, at the office of the holder, the sum $ (dollars). This note shall be due on demand upon a final forfeiture of the bond of (principal). Upon default in the payment this note, the makers and endorsers agree to pay all costs of collection, including reasonable attorney's fees of 25% in case this note is collected by or though an attorney at law, Plus and all expenses incurred a as a result of the final bond forfeiture and those expenses incurred in seeking and/or apprehending the principal. The liability of the undersigned is joint and several, and this indebtedness may be enforced against any one or more of the undersigned. I have read and do fully understand the terms and contents of this note. Principal Clear Co-Principal Clear
