AFFIDAVIT OF UNDERTAKING OF BAIL FOR SURRENDER OF DEFENDANT PERSUANT TO CALIFORNIA PENAL CODE SECTION 1300 (a)(1) PC Right and Mode of Surrender Exoneration of Sureties. 1301PC Arrest by Sureties or Under Their Authority. I ___________________________________, DECLARE THAT I AM A CALIFORNIA BAIL LICENSEE DOING BUSINESS AS: ____________________________________________________________: LICENSE NUMBER: ____________________ THE FOLLOWING INFORMATION REPRESENTS A TRUE AND CORRECT STATEMENT OF FACTS AS THEY PERTAIN TO: BAIL BOND #:______________________________ AMOUNT:__________________ DATE POSTED:____________________ DEFENDANT'S NAME:_________________________________________________________ DOB:_____________________ COURT: SUPERIOR, JUDICIAL DISTRICT:____________________________________ COUNTY:_____________________ CASE/WARRANT:_______________________________ ORIGINAL CHARGES:__________________________________________________________________________________ _____________________________________________________________________________________________________ SURETY COMPANY: SENECA INSURANCE COMPANY 160 WATER STREET, 16Th FLOOR, NEW YORK, NY 10038-4922 Bail Agent:________________________________________________________________________ Address:_________________________________________________________________________ Phone:_____________________ PERSONS AUTHORIZED TO APPREHEND AND SURRENDER DEFENDANT: Authorized to Apprehend:_____________________________________________________________ Address:__________________________________________________________________________ Phone:______________________________ I DECLARE UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT: ___________________________________________________________________________ AFFIANTS SIGNATURE _________________ DATE SURRENDER OF DEFENDANT PERSUANT TO CALIFORNIA PENAL CODE 1300 (a)(1) Right and Mode of Surrender Exoneration of Sureties. 1301PC Arrest by Sureties or Under Their Authority. I HEREBY CERTIFY that the above named defendant is now in my custody pursuant to the provisions of Section 1300(a)(1) or 1301 of the California Penal Code. __________________________________________________________________ ______________________ Officer/Deputy Badge / I.D. ___________________________________________________________________ __________________ County /City State Date