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Name of person in jail
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First Name
Last Name
Location of Jail
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Your Name
*
First Name
Last Name
Your Phone Number
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-
Area Code
Phone Number
Your Email
*
example@example.com
What is your relation to the Defendant:
Mother
Wife
Girlfriend
Spouse
Boyfriend
Father
Sibling
Friend
Grandparent
Cousin
Co-worker
Other
Defendant's Bond Amount (if known)
Defendant's Date of Birth
Defendant’s Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long has the defendant lived at the listed Address?
Defendant's Phone Number
Defendant's Email
Defendant’s Occupation
Defendant's Social Media Name
Your Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long have you lived at your current residence?
Your Date of Birth
Your Social Security Number
Read Carefully and Check all that apply to you.
You are a US Citizen
You are Employed
You own a Vehicle
You own your home
You are on parole
You are on probation
You are out on bond your self
You have pending court cases
Your Occupation
Read carefully and Check all that apply to the Defendant
The Defendant is a US citizen
The Defendant is Employed
The Defendant has prior arrests
The Defendant is a minor
The Defendant owns a house
The Defendant is on parole
The Defendant is on probation
The Defendant is homeless
Documents Needed
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PRIVACY DISCLOSURE: To protect your privacy interests, you are advised of the following:
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SUBMIT: Please Read Carefully by clicking the SUBMIT button You agree to the terms & conditions.
BAIL AGENT RECORD OF REQUEST BY FAMILY MEMBER TO SOLICIT ARRESTEE (§2079.1, Title X, CAC)
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SUBMIT: I authorize the Surety and its producers, agents and representatives to contact me and or the arrestee (defendant) for the purpose of solicitation of bail.
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