(Example only, do NOT print or fill out)

Know all men by these presents, that I, _____________________________ the undersigned, have voluntarily chosen and agreed to post Bail Bond for the defendant/inmate/principle ____________________________ in the amount of:


          I understand and agree that should the defendant/inmate/principle named above fail to appear at the place, date and time set forth in the Release and Appearance Agreement executed by said defendant/inmate/principle ALL monies posted herein as bail shall be forfeited to the Court and not returned to me and a warrant for the arrest of the defendant/inmate/principle will be issued.

          I further understand that should the defendant/inmate/principle appear at the place, date and time set forth in the aforesaid Release and Appearance Agreement and after the defendant/inmate/principle has been arraigned on any charges that may be filed as a result of his/her arrest, I may have the money posted as bail returned to me upon presentation of proper identification.

Signature of person posting bond

Subscribed and sworn before me this ____ day of _______________, 20____.


                                                                   Notary Public