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Defendant Agreement
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2021-02-05T16:23:53+00:00
Defendant Bail Agreement
All fields are mandatory. If a section does not apply to you, write NONE
Defendant Information
Defendant's Name
*
First
Last
Where Held
*
Date of Birth
*
MM slash DD slash YYYY
Current Address
*
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Email
*
Home Phone #
*
Cellular Phone #
*
Check One
*
Own
Rent
Living with Family
Monthly Payment or Rent
*
How long?
*
Court Ordered Total Amount of Bond Needed to Release Defendant
*
(Amount of bond to be posted)
SS#
*
US Citizen
*
Yes
No
ID
*
State of Issuing ID
*
Residence Alien #
*
Race
*
Sex
*
Height
*
Weight
*
Hair
*
Eyes
*
ID Marks/Tattoo
*
Yes
No
Where and What
*
Vehicle Make and Model
*
Vehicle Year and Color
*
Vehicle License# and State
*
Defendant's Attorney
*
Attorney's Phone #
*
Employment Information
Employment Type
*
W2 Employee
1099/Self Employed
Fixed income
Current Employer or Retired From
*
Employer Phone #
*
Employer Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
How long?
*
Position
*
Income (Monthly)
*
BANKING AND CREDIT INFORMATION
Bank Name
*
City
*
Checking/Savings Balance
*
Would you like to upload your identification or text it to us?
*
Upload Identification
Text photo of identification
FRONT OF YOUR ID
*
Max. file size: 64 MB.
Upload a clear picture of the front of your ID.
BACK OF YOUR ID
*
Max. file size: 64 MB.
Upload a clear picture of the back of your ID.
PROOF OF MAILING ADDRESS
*
Drop files here or
Select files
Max. file size: 64 MB.
Please upload documents such as a paycheck sub, and a utility bill.
We need your driver license or identification card, paycheck sub, and a utility bill. if you do not have a scanner please take a photo with your phone, then text to 901-523-2245. If you do not have all of this information, we will use other means to verify identity.
Credit Cards, Other Loans
1) Name
*
Company
Current Balance
*
Monthly Payment
*
Defendant's Family Information
Defendant's Mother's Name
*
Address/City/State/Zip
*
Phone
*
Defendant's Father's Name
*
Address/City/State/Zip
*
Phone
*
Defendant's Sibling's Name
*
Address/City/State/Zip
*
Phone
*
Defendant's Sibling's Name
*
Address/City/State/Zip
*
Phone
*
Defendant's Child's Name
*
Address/City/State/Zip
*
Phone
*
Defendant's Child's Name
*
Address/City/State/Zip
*
Phone
*
Defendant's Best Friend's Name
*
Address/City/State/Zip
*
Phone
*
Referral List
1) Name
*
Relationship
*
Cell Phone
*
2) Name
*
Relationship
*
Cell Phone
*
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