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About Us
How Bail Bonds Works?
Locations
Adams County
Arapahoe County
Aurora City
Denver County
Douglas County
Blog
Contact Us
(303) 995-2886
Home
About Us
How Bail Bonds Works?
Locations
Adams County
Arapahoe County
Aurora City
Denver County
Douglas County
Blog
Contact Us
(303) 995-2886
1
Defendant
2
Basic Info
3
Personal Info
4
References
SURETY BOND APPLICATION - DEFENDANT
Any person with the intention to defraud an insurer, who submits an application or claim containing a false or deceptive statement is guilty of insurance fraud.
Defendant
Phone(s)
Former Name or Alias
Birth Place
Date of Birth
MM slash DD slash YYYY
Race
Sex
Height
Weight
Eye Color
Hair Color
Glasses
Yes
No
Glasses
Beard
Mustache
Right Handed
Left Handed
Photo Taken
Yes
No
Disabilities
Other Tattos
Identifiers
Booking / Inmate #
SS#
DL#
Address
City
St
Zip
How Long
Former Address
City
St
Zip
How Long
Years in city
Years in State
Last State
Where Arrested
Co-Defendants
Failures to appear
Pre-Trial/Parole Bond/Probation
Court Cases
Out on Bail
Employer
Position
How Long
Supervisor
Employer Address
Phone extension/ Dept
Union Person
Military
Vehicle:Year
Vehicle: Make
Vehicle: Model
Vehicle: Color
Vehicle: Plate#
State
Where Financed
Amount Owned ($)
Vehicle:Year
Vehicle: Make
Vehicle: Model
Vehicle: Color
Vehicle: Plate#
State
Where Financed
Amount Owned ($)
Spouse / Partner
Phone(s)
Address
City
St
Zip
How Long
Employer
Phone(s)
Address
City
St
Zip
How Long
References
1. Name
Address(State/Zip/Street/Zip)
Phone(s)
Relationship
How Long
2. Name
Address(State/Zip/Street/Zip)
Phone(s)
Relationship
How Long
3. Name
Address(State/Zip/Street/Zip)
Phone(s)
Relationship
How Long
Emergency Contact
Phone(s)
Address
City
St
Zip
How Long
Transiation Request - Solicitud de traduccion:
(1 Check this box (Marque esta casilla) If indemnitor or Defendant requires Agreement to be read to them or if Producer or Third Party has translated this dacument for signer. Hf checked, Producer must complete a separate Transiation Affidavit pursuant to C.R.S. 10-2-705; Bail Bond documents - requirements - rules (1)(VI)
I hereby represent and warrant that the foregoing information is true, complete and correct and is made for the purpose of inducing Universal Fire & apprehension and/or recovery. Casualty Insurance Company to issue, or cause to be issued, bail bond(s) for the defendant referred to herein. Any information provided can be used for apprehension and/or recovery.
Signature
Date
MM slash DD slash YYYY
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