DEFENDANT AUTHORIZATION FORM

DEFENDANT AUTHORIZATION FORM
Defendant Name:
First and Last Name
Name of Bail Agent:
First and Last Name
Name of Bail Bond Company:
By signing my name below, on this date, I authorize the bail bond agent named herein to execute bail bonds on behalf of myself or the person I represent. I understand that this will begin the bail bond process.

NOTE: If I am signing this form as a duty designated representative of the defendant, I certify that I am at least 18 years of age and that I have full permission of the defendant to enter into this agreement.
Signature of Defendant or Authorized Representative
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Printed Name
of Authorized Representative (if applicable)
I agree

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