Bail Agents Information
Name
*
First Name
Last Name
BAIL AGENT LIC #
*
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Defendant's Information
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Date of Birth
*
Social Security Number
*
last known Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
CLEAR FACE PICTURE
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Physical Description
*
Sex/ Race/ Height/ Weight/ Hair/ Eyes/ Tattoos/ Marks or Scars/
Known Hangouts
*
Please List any known hangouts or neighborhoods
Additional information
*
Please list all family members and contact information
Bail Bond Information
Total Bond Amount
*
Case Numbers
*
Please list all active case numbers
Booking Number
*
Felony or Misdemeanor
*
Please Select
Felony
Misdemeanor
List of all Charges
*
Please list all active criminal charges
Reason for Forfeit / Surrender
Please Select
Missed court date
Missed Check in date
failure to comply with the confinds of the contract
Reinstatement Eligible?
*
Please Select
YES
NO
Are you allowing for the defendant to be reinstated for this bond?
Last court Date the Defendant Skipped
*
-
Month
-
Day
Year
Date
Last Point of contact with Defendant
*
-
Month
-
Day
Year
Date
Drop Dead Date/ Bond Expire Date
*
-
Month
-
Day
Year
Last day to make Arrest, Reinstate, Exonerate
Any Extentions Filed for this Case?
*
Please Select
YES
NO
List Any or All Court Dates
*
Please list any or all court dates, hearings, motions filed
Upload Case File Here
*
Browse Files
Drag and drop files here
Choose a file
Please upload ENTIRE case file here as a single PDF
Cancel
of
Payment
Fugitive Investigation or Pickup?
Please Select
Fugitive Investigation
Fugitive Pickup
Fugitive Investigation is 10% of the total bonded amount. Fugitive Pickup Fee is $700.00
Recovery Payment Amount
*
All payment are non-refundable. Do you agree to pay the amount?
*
Please Select
YES
NO
Authorization
I authorize for California Fugitive Apprehension Agency and or its Agents to apprehend the above listed defendant and will assume any or all criminal / civil damages that might occur to the defendant or others involved during the course of this apprehension.
*
Please Select
Sign Here
*
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