BAIL BOND APPLICATION - INDEMNITOR (2026)

BAIL BOND APPLICATION - INDEMNITOR (co-signer)

Mr Jones Bail Bonds (lic #147)1100 Mulcahy Street, Rosenberg, Texas 77471(281) 239-3677info@MrJonesBailBonds.comwww.MrJonesBailBonds.com
Defendant Information
Defendant Name

First NameLast Name
Birth Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Charges
Appearance Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Case Number
Court Name
Indemnitor (co-signer) Information
Indemnitor (co-signer) Name

First NameLast Name
My friends / family know me as
Home Phone Number
Format: (000) 000-0000.
Cell Phone Number
Format: (000) 000-0000.
Work Phone Number
Format: (000) 000-0000.
Relationship to Defendant
Email
example@example.com
Current Full Address, City, State and Zip

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current Address Status
Current Address From

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Current Address To (if still live here type "current")
Landlord Name (if applicable)

First NameLast Name
Landlord Phone Number
Format: (000) 000-0000.
Former Full Address, City, State and Zip

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Former Address Status
Former Address From

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Former Address To

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Former Landlord Name (if applicable)

First NameLast Name
Former Landlord Phone Number
Format: (000) 000-0000.
Gender
Birth Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Birth Place

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Social Security Number
Driver's License / ID Number
State Issued
U.S. citizen?
Alien Number
How long in US?
Employer (if unemployed state retired, disabled, receiving benefits, etc)
Position
How Long
Reference Name 1

First NameLast Name
Reference 1 DOB

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Reference 1 Relationship to Indemnitor
Reference 1 Phone Number
Format: (000) 000-0000.
Reference Name 2

First NameLast Name
Reference 2 DOB

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Reference 2 Relationship to Indemnitor
Reference 2 Phone Number
Format: (000) 000-0000.

IMPORTANT FRAUD WARNINGS
NOT FOR USE IN PUERTO RICO
SEE NEXT PAGE FOR APPLICABLE FRAUD WARNINGS.

ALABAMA RESIDENTS
Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or who knowingly presents false information in an application for insurance is guilty of a crime and may be subject to restitution fines or confinement in prison, or any combination thereof.

ARKANSAS RESIDENTS
Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.

CALIFORNIA RESIDENTS
For your protection California law requires the following to appear on this form: Any person who knowingly presents false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison.

FLORIDA RESIDENTS
Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree.

LOUISIANA AND MAINE RESIDENTS
It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties may include imprisonment, fines or a denial of insurance benefits.

MARYLAND RESIDENTS: Any person who knowingly or willfully presents a false or fraudulent claim for payment of a loss or benefit or who knowingly or willfully presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.

NEW JERSEY RESIDENTS
Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties.

NEW MEXICO RESIDENTS
Any person who knowingly presents a false or fraudulent claim for payment or a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to civil fines and criminal penalties.

NEW YORK RESIDENTS
Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime, and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation.

OHIO RESIDENTS
Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud.

OKLAHOMA RESIDENTS
WARNING: Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes any claim for the proceeds of an insurance policy containing any false, incomplete or misleading information is guilty of a felony.

PENNSYLVANIA RESIDENTS
Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person criminal and civil penalties.

RHODE ISLAND, TENNESSEE, VIRGINIA, WASHINGTON, AND WEST VIRGINIA RESIDENTS
It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties may include imprisonment, fines or a denial of insurance benefits.

Mr Jones Bail Bond Service Agreement & Terms
ATTENTION: Prior to release from jail, the defendant’s name will be compared to a national database for outstanding warrants. If the defendant has an active warrant in another county or state, the defendant may not be released from jail until those warrants are rectified. If the defendant has outstanding probation or other county or state fees, the defendant may not be released until those fees are rectified. Once bond(s) are accepted by the jail, they cannot be canceled - no refunds will be given. This contract is between Mr Jones Bail Bonds (the "Business") and Indemnitor co-signer (the "Client"). The Client is hiring the Business for Bail Bonds services described in the contract.
Statement of Charges
Upon completion of preparing the bail bond(s), the Business will provide the Client with the statement of charges to pay. The Client agrees to pay and understands that the premium owing or paid in the Statement of Charges is fully earned upon the Defendant’s release from custody, and the fact that the Defendant may have been improperly arrested, re-arrested, the case dismissed, or the bail reduced shall not obligate the return or forgiveness of any portion of the premium except as otherwise provided by applicable law (if any) as stated in the Bail Bond Agreement.
Payment Methods
Payment will be made to the Business via cash, check, an approved payment card, Venmo, PayPal or by any other payment method determined by the Business.
No Refunds
The Customer will be assumed to have accepted the bail bond(s) unconditionally unless a claim that the bail bond(s) are made void by the jail due to previous release of Defendant from jail.
Licensing
The Business promises that it is licensed in Fort Bend County to perform bail bonding, that the license is valid and effective as of the date any work is performed or services provided, and that all work performed or services provided will be done in compliance with all applicable federal, state, or local laws and regulations.
Authority to Sign
Each party has the authority to enter into this Contract and to perform all of its obligations under this Contract.
Termination of contract
The Contract ends on date the defendant cases/bonds are disposed, surrendered or bond forfeited. The Client is responsible for paying for all cost and fees owed.
Modifications
The Client and the Business must agree to any changes to this contract in writing.
This contract may be signed electronically or in hard copy. If signed in hard copy, it must be returned to the Business for valid record. Electronic signatures count as original for all purposes.

Supporting Documents
Upload supporting documents: picture ID, proof of residency (ie utility bill) and proof of income (ie pay stub)

Cancelof
Authorized Signatures
I hereby represent that the foregoing information is true, complete and correct and is made for the purpose of inducing Allegheny Casualty Company to issue, or cause to be issued, bail bond(s) for the defendant referred to herein.
Signed, sealed and delivered this

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Indemnitor (co-signer) Signature
Should be Empty:

BAIL BOND APPLICATION - INDEMNITOR (co-signer)

Defendant Information

Indemnitor (co-signer) Information

IMPORTANT FRAUD WARNINGS

Mr Jones Bail Bond Service Agreement & Terms

Statement of Charges

Payment Methods

No Refunds

Licensing

Authority to Sign

Termination of contract

Modifications

Supporting Documents

Authorized Signatures