Bail Bond Forms

Wake County Bail Bondsman and FreemasonPlease fill out the form below completely. If you have any questions, please call us at 919-821-9998. You can jump to different sections of the form by clicking the links below.

Deposits

Please note the percentage of the bond premium varies on a case-to-case basis and financing options are available. You may pay online using our PayPal account by clicking the button in the sidebar.

YOU MUST FILL OUT ALL PARTS OF THE FORM BEFORE YOU SUBMIT.


Client Information

First Name:

Middle Name:

Last Name:

Nickname:

Date of Birth:

Place of Birth:

Sex:
Height:

Weight:

Race:

Eye Color:

Hair Color:

Complexion:

Identifying Marks / Scars / Tattoos:

Social Security Number:

Drivers License Number:

Street Address:

City:

State:
Zipcode:

Home Phone:

Cell Phone:

Vehicle 1
Vehicle Make:

Year:

Model:

Color:

Plate:

State:
Vehicle 2
Vehicle Make:

Year:

Model:

Color:

Plate:

State:

Employment

Current Employer:

Address:

Phone Number:

Supervisor Name:

Years Employed:

Comments:


Children

Name:

Age:

School:
Name:

Age:

School:


Personal References

Reference 1
Name:

Address:

Phone:

Relationship:

Employer:
Reference 2
Name:

Address:

Phone:

Relationship:

Employer:

Reference 3
Name:

Address:

Phone:

Relationship:

Employer:


Indemnitor Information #1

First Name:

Middle Name:

Last Name:

Drivers License Number:

Social Security Number:

Date of Birth:

Address:

Relationship:

Home Phone:

Cell Phone:

Employer's Name:

Employer's Address:

Employer's Phone Number:

Number of Years & Months Employed:

Name of Spouse:

Vehicle Year:

Make:

Model:

Color:

Plate:

State:


Indemnitor Information #2

First Name:

Middle Name:

Last Name:

Drivers License Number:

Social Security Number:

Date of Birth:

Address:

Relationship:

Home Phone:

Cell Phone:

Employer's Name:

Employer's Address:

Employer's Phone Number:

Number of Years & Months Employed:

Name of Spouse:

Vehicle Year:

Make:

Model:

Color:

Plate:

State:


Consent for Release of Information

I, hereby authorize the release of information from the North Carolina Department of Motor Vehicles, the Social Security Administration, the state Department of Disability Insurance, the Internal Revenue, any entity of the U.S. Armed Forces, parole or probation officer, the U.S. Postal Service, Bus Stations, Transportation Agencies, any present and/or past landlords, employers, doctors, hospitals, banks/financial institutions, telephone/wireless providers, any utility companies, all Municipal, County, State and Federal and Law Enforcement agencies and any other persons or organizations that have information pertaining to the undersigned that would assist in securing the defendant's appearance in court to produce that information to Access Bail Bonds and/or Alleghany/International Surety Company.

I hereby request that Access Bail Bonds in addressing the matter described above, and authorize Access Bail Bonds/Bobby G. Judd and its assigns and/or duly authorized representatives.

Full Name of Defendant:


Defendant's & Indemnitors' Indemnity Agreement & Guarantee

State of North Carolina
County of

Defendant:

Indemnitor 1:

Indemnitor 2:

Bail Amount ($):

Bail Bondsman:

I, the Defendant, Indemnitor 1, and Indemnitor 2, acting and being obligated as surety on bail bond in the amount listed above do guarantee the payment of said bond to the Bail Bondsman, in the event of forfeiture by the above named principal. I specifically waive notice of acceptance of this guaranty, acknowledge myself as fully bound by all provisions of the above stated bail bond, and expressly agree to pay, upon demand, any amount owing, not to exceed the amount of forfeiture ordered hereunder, and I do hereby agree to indemnify and hold harmless the above Access Bail Bonds/Bobby Judd or its assigned representative/agents/Alleghany Casualty Company, for such amounts is required to pay upon such forfeiture. This agreement is void upon termination of liability on the bail bond as provided by North Carolina Administrative Code T11 13.0512.

It is further agreed defendant will be returned to jail, without refund of bond premium for any of the following:

  1. Willfully fails to pay the premium to the surety of willfully fails to make premium payment under the agreement specified in G.S. 58-71-167.
  2. Changes his or her address without notifying the surety before the address change.
  3. Physically hides from the surety.
  4. Leaves the State without permission of the surety.
  5. Violates any order of the court.
  6. Knowingly provides the surety with incorrect personal identification, or uses a false name or alias.
  7. Fails to disclose information or provides false information regarding any failure to appear in court, any previous felony convictions within the past 10 years, or any changes pending in any State or Federal court.

Please leave this field empty.
I understand that by checking the acceptance box, I am stating that the form above is completed truthfully and accurately, and that I am fully and legally responsible for the terms and conditions of this bail bond contract.
Full Name:

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