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Indemnity Bail Bond
Application and Agreement
Relationship to Def:__________________Referred By:_______________________Indemnitor Sex: M/F_____________________
Indemnitor’s Full Name_________________________________________________________________________________________________
AKA_______________________________________Scars/Marks/Tattoos________________________________________________________
Social Sec No._________-________-__________ Date OF Birth________/________/19_______Race__________________________________
Height_____________ Weight_________ __Eye Color__________ Hair__________ Place of Birth____________________________________
DL#___________________________________________________________ State____________________ Exp_________________________
Address____________________________________________________Apt#________City/Town_____________________________________
State_________ Zip Code____________________ Own/Rent Landlord/Lives With_________________________________________________
How Long at Current Address______________________ years/months Lease Expires_______________________________________________
Previous Address________________________________________Apt#__________City/Town_______________________________________
Home Phone(___________)_____________-_________________ Cell Phone(___________)_____________-___________________________
Email______________________________________________________Facebook:_________________________________________________
Present Occupation(s)_________________________________________________Employer__________________________________________
Address______________________________________________City/town___________________________________Zip__________________
Phone#(__________)___________-_____________Ext__________ How Long_________ Annual Income$_____________________________
Auto Year ____________Make ____________Model __________________ Color____________ Tag# ___________________State _________
Amount Owed$_______________ Lien Holder____________________________InsuranceCompany___________________________________
Bank________________________ Branch____________________________________ Account Type__________________________________
Real Property________________ In Who’s Name__________________________________________________ How Long_________________
Lot
Block
Est.Value$
Mortgage Total$_________
Spouse Full Name _________________________________________Maiden Name________________________________________________
Date of Birth_______/______/19________ Social Sec. No________-________-_________DL#_______________________________________
Occupation(s)________________________________________________Employer_________________________________________________
Address____________________________________City/town___________________________________Zip____________________________
Phone#(______)_______-__________Ext______ How Long_____________ Title____________________ Shift__________________________
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Refrences
Adresss
Phone
_________________________________________________________________________________________________
1________________________________________________________________________________________________
_________________________________________________________________________________________________
2________________________________________________________________________________________________
_________________________________________________________________________________________________
3________________________________________________________________________________________________
_________________________________________________________________________________________________
4_______________________________________________________________________________________________
__________________________
Signature
_________________________ ____________________
Print
Please Fill Out The Entire Application!!!!
Date
YOU ARE ASSUMING SPECIFIC OBLIGATION- READ CAREFULLY!
INDEMNITY AGREEMENT FOR SURETY BAIL BOND
AMERICAN SURETYCOMPANY
THIS AGREEMENT is made by and between the undersigned Defendant, Indemnitors, and AMERICAN SURETYCOMPANY Through its duly
authorized Agent:__________________________________________________________________________________________
WHEREAS , AMERICAN SURETYCOMPANY(HEREINAFTER CALLED “SURETY”), AT THE REQUEST OF THE Indemnitor has or is
about to become the SURETY on an appearance bond for Defendant in the sum of _______________________________________
Dollars $(________________________________________)
by its certain executed on power of attorney number(s)______________,_________________,______________________,________________,______________
NOW, THEREFORE, in consideration of the mutual promises and covenants contain herein the parties jointly and severally agree as follows:
_______1: That the Indemnitor will have Defendant forthcoming before the Court named on said Bond at the time(s) therein fixed, and at such other time as may
be ordered by the Court.
_______2: That the Indmnitor will at all times indemnify and save the Surety harmless from and against any and all claims, demands, liabilities, costs, charges,
counsel fees, expenses, suits, orders, judgment, or adjudications whatsoever which the Surety shall or may for any causes sustain by reason of Surety having
executed said Bond or undertaking, and will, upon demand, place the Surety in funds to meet all such claims, demands, liabilities, costs, charges, counsel fees,
expenses, suits, orders, judgments, or adjudications against it, by reason of its Suretyship, and before the surety shall be required to pay the same.
_______3: That the agreement of Indemnity contained in Paragraph 2 above shall continue as long as the SURETY has any liability or has sustained any loss,
upon the bond referred to herein, and the undersigned further agrees not to make any transfer, or any attempted transfer of any of the property, real or personal ,
in which the undersigned has any interest or in which the undersign may subsequently acquire any interest, and it is further agreed that the SURETY shall have a
lien upon all property of the undersigned for any sum due it or for which it has become, or may become, liable by apply to any subsidiary, affiliate, parent or
related enterprise created or acquired by the undersign.
_______4: That the voucher or any other evidence of any payment made by the SURETY, by reason of this suretyship, shall itself, be conclusive evidence of
such payment as to the Indemnitor, their estate, and those entitled to share in their estate, and their successors and assigns.
_______5: That the SURETY may withdraw, at any time provided by law, from its Suretyship upon the Bond or undertaking herein, without liability to any
party.
_______6: That Indemnitors’ liability to Surety is not limited to the Bond referred to herein, but shall apply to all other bonds or undertaking issued by SURETY
at the request of the Indemnitors.
_______7: That Indemnitors’ obligation and indemnities as contained herein shall not terminate upon exoneration of the bond or undertaking but shall continue
until such time that SURETY is relieved of all duties, demand, liabilities, obligation, costs or expenses in any way related thereto.
_______8: That the wavier by the SURETY of any breach of any term or condition herein shall not be deemed a waiver of same of any subsequent breach of the
same term and condition, ant that failure of any Indemntior to comply with the terms and conditions herein shall not act as or be constructed as a release or
wavier as to the remaining Indemnitor who shall remain liable and bound by all provision of this AGREEMENT.
_______9: This Agreement shall be constructed and enforced under the laws of the STATE OF NEW JERSEY, In the event any of the provisions of this
Agreement are inconsistent with the laws of this State, this Agreement, as to these provisions only, shall be null and void, and the remainder shall be enforced
with the same effect as though such provisions were omitted.
_______10: The use of the plural herein shall include the singular. Obligation of the Indemnitors shall be joint and several and the provision of this Agreement
shall be binding upon Indemnitors’ heirs, successors, representatives and assigns.
IN WITNESS WHEREOF, the First Party whose names are subscriber to the Indemnity Agreement executed herewith each represents; I have read the
Indemnity Agreement and I know the contents thereof; that I Hereby acknowledge receipt of a copy of said Indemnity Agreement; that I am the true and lawful
owner of the property, whether real or personal, which if set forth in the Application for Bail(which Application is made a part hereof by reference as thought
herein fully set forth) is my property and that I own such property free and clear of all liens or encumbrances except as so noted, and I further promise not to
transfer or encumber any of said property until my liability on said Indemnity Agreement has been released. I understand the Second Party and/or Surety is
permitting the said bail to remain in force upon reliance of the statement made by me and I do hereby.
This__________________ Day Of ____________________ , 20________ set my hand
X__________________________________________________________
INDEMNITORS SIGNATURE
X___________________________________________________________
X _______________________________________________________________
PRINT NAME
INDEMNITOR/GUARANTOR
CHECKLIST
BOND NO.:________________________
Date : __________________________
Defendant :______________________
Jail :____________________________
Bail
Amount:___________________________________
Premium
Amount:___________________________________
Amount
Paid Down:________________________________
Unpaid
Balance:__________________________________
Cash
Collateral:_________________________________
(Initial Here)
_________1. I have read and received a copy of the standard surety bail bond agreement.
_________2. This indemnitor/guarantor checklist is intended to clarify and explain the standard surety bail bond
agreement.
_________3. I understand I am responsible to make the payments for money due on the premium as described above.
Finance charges are computed on unpaid balances on the 30th day of each month at a rate of ten percent
per annum. There is a_________ percent late fee on all scheduled payments not received within five
days of the due date.
_________4. I understand I am required to pay the amount of the bail premium every year in advance hereafter, until
the surety is legally discharged from all liability on the bond(s) posted.
_________5. I understand I am responsible for paying the full amount of the bond posted if the defendant does not
appear in court, for every appearance and any other time ordered by the court, until defendant is
sentenced or the court dismisses the case.
_________6. The court will enter a forfeiture of the bail if the defendant fails to make any court appearance. I
understand that if the bond is ordered forfeited and it is not ordered reinstated, or exonerated that I must
pay the full amount of the bail forfeited to the bail agency.
_________7. I understand I am responsible if it becomes necessary to arrest and surrender the defendant. That I am
responsible for paying for investigation, location and apprehension time: this is billed at a rate of______
per hour per investigator plus expenses or______ percent of bond whichever is greater.
Investigation costs will begin to accrue after a court forfeiture or when any co-signer requests the
defendant be placed back in custody or when any condition exists as defined in the bail bond agreement.
Specifically, but not limited to Sections Five and Eleven. If no investigation costs have been incurred prior
to a voluntary surrender of defendant at the jail facility of the court specified on the bail receipt there will
be no investigation cost charged. Reasonable court costs. as described in Paragraph 8 of this checklist,
will be charged if applicable and a receipt will be provided.
_________8. I understand that if the bail is ordered forfeited by the court. that I am responsible to pay court costs and
reasonable appearance fees (a minimum of_____________ ) for the bail agency to reinstate or
exonerate the bail bond if necessary.
_________9. I understand that if I breech the bail bond agreement. by non-payment or any other action as defined by
the bail agreement, I am responsible for any collection actions taken, including attorney fees and costs.
Attorney’s fees are a minimum of_______ an hour. If any collection action needs to be
taken a minimum_________ fee will be charged.
_________10. I understand that collateral cannot be released until all bonds posted on my behalf for the defendant have
been exonerated, and written notice from the court provided to the bail agency.
_________11. I understand that substitution of collateral is done at the discretion of the surety and the bail-bonding
agency. There are no agreements to substitute collateral at a future date.
_________12. I understand that it is my responsibility to request return of any collateral provided. There may be a delay
of return of collateral until the bail agency has researched the exoneration date and verified the bail bond
status with the appropriate courts. This process may be done faster if I obtain written verification of the
bond exoneration from the court and provide it to the bail agency.
_________13. This checklist is intended to explain and clarify the standard bail agreement, which is the entire contract
with the bail agency. There are no additional terms nor are there any exemptions to the contract either in
writing or verbally, that limit my responsibility under the bail agreement.
_________14. I declare that all statements made on the application and financial statements are true. I agree to notify
the bail agency within 48 hours of any changes, including but not limited to any change of address or
employment of either the criminal defendant or myself.
_________15. I understand the obligation under this agreement is joint and several. This means that I may be held
solely and individually liable for up to the full amount owed for any and all charges, even if there are other
cosigners on the agreement.
_________16. Agreement of Venue: I agree that if legal action between the parties concerning this bail bond is brought,
it shall be brought in and before a federal or state court in______________________________ County
in the State of ____________________________________.
I HAVE READ AND AGREE WITH THE ABOVE DECLARATIONS AND UNDERSTAND MY
RESPONSIBILITIES AND OBLIGATIONS AS INDEMNITOR/GUARANTOR. 

SIGNATURE:___________________________________ PRINT NAME::_____________________________________
INDEMNITOR’S RESPONSIBILTY
PLEASE INITIAL
1_____ It is the responsibility of the Indemnitor to ensure that the defendant checks in with DEPENDABLE BAIL
BONDS, LLC weekly via telephone 732-317-8296 and monthly in person at 226 US Highway 1 N Suite N Edison NJ
08817 Mon-Fri 9am-4pm
2_____ It is the responsibility of the Indemnitor to ensure the defendant attends all court dates.
3_____ Indemnitor must inform DEPENDABLE BAIL BONDS, LLC if any of their personal information changes.
(phone numbers, address & employment)
4_____ In the event of a forfeiture, Indemnitor gives permission to DEPENDABLE BAIL BONDS, LLC and its affiliates
to search their home and agrees to assist with all apprehension efforts.
5_____ Indemnitor understands that if there is a change to the relationship status with the defendant, this does not excuse
the indemnitor of their obligations and legal contract with DEPENDABLE BAIL BONDS, LLC
6_____ Indemnitor understands that they are responsible for the bond until the conclusion of the case.
7_____ Indemnitor understands that the bail bonds agent/agency has no control of jail procedures.
8_____ Indemnitor has been informed of jail procedures and understands the possibility of warrants arising after posting.
Indemnitor understands the agent/agency is not responsible for this.
9_____ Indemnitor understands that the bail premium is a fee for service and is non-refundable after bond execution,
regardless of a case’s disposition.
10_____ Indemnitor is responsible to ensure that all payments for the Premium (10%) are to be paid to DEPENDABLE
BAIL BONDS, LLC Indemnitor understands that if there are any changes to the defendant’s status upon their release,
they are still responsible for payment of the full premium.
11_____ If Applicable: Indemnitor understands that they are responsible to ensure that regular payments are being made.
Payment agreement is as follows: Minimum payments are to be $________ per _________ until the balance is paid in full.
12_____ Indemnitor understands that if the defendant is re-arrested for any reason DEPENDABLE BAIL BONDS,
LLC has the right to request that any unpaid balance be paid in full within 7 days and may pursue with bail bond
revocation.
13_____ Indemnitor understands that if the defendant’s case is resolved before an account balance is paid in full, the unpaid
balance is due in full within 7 days of adjudication.
14_____ Indemnitor understands that if a payment is missed, the balance in full is due on demand (we may demand
payment or work out a solution).
15_____ Indemnitor understands that in the event of a forfeiture they are responsible for all fees set by the courts which
can be up to 100% of the bond and any legal and recovery fees to be paid immediately.
16_____ Indemnitor understands that if payments are defaulted or there is an outstanding financial balance with
DEPENDABLE BAIL BONDS, LLC the account is subject to being turned over to a third party collections agency. Indemnitor
then becomes subject to that collection agency’s fees and repercussions in addition to the balance owed to
DEPENDABLE BAIL BONDS, LLC .Indemnitor will be responsible to pay the collection agency’s fee, any attorney
fees and/or court costs in connection with any and all legal action taken to recover payment on the account.
I have read and agree to all conditions. I have received a copy of these conditions. I also understand that these are NOT the only
conditions that I am obligated to, but I am also responsible to the conditions of the courts, DEPENDABLE BAIL BONDS, LLC and
their affiliates.
SIGN______________________________________PRINT_______________________________DATE________/___________2015
SURETY’S RIGHT TO SEARCH
Name of Defendant: ____________________________________________________
I ________________________________________________ understand and agree to the following:
In the event that the defendant noted above fails to appear in court, or at the office of the company whenever so
required, or if any financial statement and/or personal information on my part shall be found to be false or untrue, or if
any of the collateral or security given shall depreciate, or have become impaired, DEPENDABLE BAIL BONDS,
LLC and the company’s affiliates shall have the right to surrender/re-arrest the defendant.
I fully understand and agree that if the defendant noted above fails to appear in court or in the office of
DEPENDABLE BAIL BONDS, LLC, the surety in person or by agents shall have the right to search my home at any
time of the day or night. The surety and his agents may enter my home to search for the defendant and arrest the
defendant. I voluntarily waive my privacy rights and hold the bonding company and agents harmless for any property
damages, in the event that I refuse entry to my residence.
Agreement
Defendant Name: _________________________________________________________________________________
Bond Amount: _______________________________ Power No.: _________________________________________
Pursuant to N. J. A. C. 11: 1-40.3, AMERICAN SURETY COMPANY, may charge a fugitive fee which is:
1. The greater of $1500 or 10 percent of the amount of the bail bond for a fugitive who is either apprehended or located
while in custody within the State of New Jersey; or
2. The greater of $1500 or 20 percent of the amount of the bail bond for a fugitive who is either apprehended or located
while in custody outside the State of New Jersey.
Notwithstanding any computation to the contrary made pursuant to the above, in no event shall an indemnitor’s
obligation to pay a fugitive fee exceed 110 percent of the face amount of the bail bond.
_____________________________________
Signature of Indemnitor
___/___/_____
Date
_____________________________________
Signature of Defendant
___/___/_____
Date
PROMISSORY NOTE
This promissory note (the “Note”) is made effective this _____ day of _______________
20_____, by ________________________, an individual who currently resides at
____________________________________________, hereinafter referred to as (“Borrower”)
promises to pay DEPENDABLE BAIL BONS, LLC, located at EDISON, New Jersey
08817 hereinafter referred to as (“Lender”).
PROMISE TO PAY: For Value Received, the Borrower promises to pay to the Lender, the
principal amount of ____________________________________ Dollars ($_____________),
together with interest accruing on the unpaid balance thereof until due.
REPAYMENT: The amount owed under this Note will be repaid pursuant to the following
terms: monthly payments of _________ beginning ________________ and on the ______ day
of each month thereafter until balance is paid with an interest of zero percent.
ADDITIONAL COSTS: In case of default in the payment of any principal of this Note,
Borrower will pay to Lender such further amount as will be sufficient to cover the cost and
expenses of collection, including, without limitation, reasonable attorney’s fees, expenses, and
disbursements. These costs will be added to the outstanding principal and will become
immediately due.
PREPAYMENT: Borrower may prepay all or any part of principal without penalty.
AMENDMENT; MODIFICATION; WAIVER: No amendment, modification or waiver of
any provision of this Note or consent to departure there from shall be effective unless by written
agreement signed by both the Borrower and the Lender.
SUCCESSORS: The terms and conditions of this Note shall inure to the benefit of and be
binding jointly and severally upon the successors, assigns, heirs, survivors and personal
representatives of the Borrower and shall inure to the benefit of any holder, its legal
representatives, successors and assigns.
BREACH OF PROMISSORY NOTE: No breach of any provision of this Note shall be
deemed waived unless it is waived in writing. No course of dealing and no delay on the part of
Lender in exercising any right will operate as a waiver therof or otherwise prejudice rights,
powers, or remedies. No right, power, or remedy conferred by this Note upon Lender will be
exclusive of any other rights, power, or remedy referred to in this Note, or now or hereafter
available at law, in equity, by statute, or otherwise.
SEVERABILITY: Should any provision of this note be deemed invalid or in violation of any
law, that section shall be deleted and or removed. The remainder of the note shall remain in full
force and effect.
GOVERNING LAW: The validity, construction and performance of this Note will be governed
by the laws of New Jersey, excluding that body of law pertaining to conflicts of law. The parties
hereby indicate by their signatures below that they have read and agreed with the terms and
conditions of this agreement in its entirety.
IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be
executed as of the date above written.
X __________________________________
________________________, Individually
Borrower
State of New Jersey
County of ______________
Subscribed and sworn to before me on this ______ day of ___________ 20_________.
MY COMMISSION EXPIRES:___________20
_________________________________
Notary Public
COPY OF INDEMNITOR’S RESPONSIBILTIES FOR THEIR RECORDS
1.
It is the responsibility of the Indemnitor to ensure that the defendant checks in with DEPENDABLE BAIL BONDS, LLC weekly via
telephone 732-317-8296 and monthly in person at 226 US Highway 1 Edison NJ 08817. It is the responsibility of the Indemnitor to
ensure the defendant attends all court dates.
2.
Indemnitor must inform DEPENDABLE BAIL BONDS, LLC if any of their personal information changes. (phone numbers, address
& employment)
3.
In the event of a forfeiture, Indemnitor gives permission to DEPENDABLE BAIL BONDS, LLC and its affiliates to search their
home and agrees to assist with all apprehension efforts.
4.
Indemnitor understands that if there is a change to the relationship status with the defendant, this does not excuse the indemnitor of
their obligations and legal contract with DEPENDABLE BAIL BONDS, LLC
5.
Indemnitor understands that they are responsible for the bond until the conclusion of the case.
6.
Indemnitor understands that the bail bonds agent/agency has no control of jail procedures.
7.
For MCCI: Indemnitor has been informed of jail procedures and understands the possibility of warrants arising after posting.
Indemnitor understands the agent/agency is not responsible for this.
8.
Indemnitor understands that the bail premium is a fee for service and is non-refundable after bond execution, regardless of a case’s
disposition.
9.
Indemnitor is responsible to ensure that all payments for the Premium (10%) are to be paid to DEPENDABLE BAIL BONDS, LLC
Indemnitor understands that if there are any changes to the defendant’s status upon their release, they are still responsible for
payment of the full premium.
10. If Applicable: Indemnitor understands that they are responsible to ensure that regular payments are being made. Payment agreement
is as follows: Minimum payments are to be $________ per _________ until the balance is paid in full.
11. Indemnitor understands that if the defendant is re-arrested for any reason DEPENDABLE BAIL BONDS, LLC has the right to
request that any unpaid balance be paid in full within 7 days and may pursue with bail bond revocation.
12. Indemnitor understands that if the defendant’s case is resolved before an account balance is paid in full, the unpaid balance is due in
full within 7 days of adjudication.
13. Indemnitor understands that if a payment is missed, the balance in full is due on demand (we may demand payment or work out a
solution).
14. Indemnitor understands that in the event of a forfeiture they are responsible for all fees set by the courts which can be up to 100% of
the bond and any legal and recovery fees to be paid immediately.
15. Indemnitor understands that if payments are defaulted or there is an outstanding financial balance with DEPENDABLE BAIL
BONDS, LLC the account is subject to being turned over to a third party collections agency. Indemnitor then becomes subject to
that collection agency’s fees and repercussions in addition to the balance owed to DEPENDABLE BAIL BONDS, LLC Indemnitor
will be responsible to pay the collection agency’s fee, any attorney fees and/or court costs in connection with any and all legal action
taken to recover payment on the account.
Dependable Bail Bonds
226 US Highway Suite N Edison NJ 08817
P 732-317-8296
F 732-317-8297
[email protected]
Plain Talk Contract
Contract Date:
Power No.
_________________
_____________________________
Bond Amount: ______________________________
Premium Amount: ________________________________
I understand that in signing this bond for obtaining the release of the defendant, ___________________________________________________
that I am responsible for him/her appearing in Court each time he/she is ordered: also, if he/she fails to follow any and all instructions or orders
of the Court or Forfeits this bond, and it becomes necessary to apprehend and surrender him/her to the Court, I understand that I am responsible
for any all expenses incurred as a result of such forfeiture and further, if such a forfeiture occurs and defendant is not surrender to the Court
within the time prescribed by law, I understand that I am required to pay the FULL AMOUNT of the bond posted, including any unpaid bail
premium.
I further understand that the premium owing and/or paid on this bond is fully earned upon the release of the defendant from custody.
The fact that the defendant may have been improperly arrested, or his/her bail reduced, or his/her case dismissed, shall not obligate the
return or forgiveness of any portion of the premium.
Important Notice
THERE IS A WAITING PERIOD OF APPROXIMATELY 30 DAYS FROM THE DATE THE BOND IS EXONERATED BEFORE
COLLATERAL CAN BE RETURNED. WE MUST RECEIVE WRITTEN NOTICE FROM THE CLERK OF THE COURT.
I am not a paid signer, I have no connection with a Bail Bond Consultant. I have read the above contract and Understand it, and agree to fulfill
All OF THE PROVISIONS THEREIN.
Signed: DEFENDANT
______________________________________
INDEMNITOR
_______________________________________
AGENT
______________________________________