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Hunter Payless Bail Bonds

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					                                                            Hunter Payless Bail Bonds
                                                              2814 The Plaza Road
                                                               Charlotte, NC 28205

CLIENT INFORMA TION

First: ________________________ Middle: _______________Last: _________________________Nickname: ___________________
Maiden Name(s): ____________________________________SS#________ -______ -_________ DOB_______ / _______ / _______
Address 1:__________________________________________City_________________________ State______ Zip_______________
Address 2:__________________________________________City_________________________ State______ Zip_______________
Resident Type: ______________________________________ How Long? __________________ Land Lord: ___________________
Previous Address 1:___________________________________City_________________________ State ______Zip_______________
Previous Address 2:___________________________________City_________________________ State______ Zip_______________
Cell Phone# _________________________ Home Phone# ________________________ Work Phone# ________________________
Height_______________ Weight _________________Hair _______________ Eyes ____________ Build _______________________
Race__________________ Sex ______________Complexion ____________________ Scars/Tattoos _________________________
City of Birth: ___________________________ State of Birth: ________________________ Nationality: ________________________
Marital Status: _______________________________________ Mother’s Maiden Name: ____________________________________
Driver’s License #:_______________________________ State________________ Expiration Date: ___________________________
Car make: ___________________________________ Car Model: _______________________________ Year: __________________
Color: __________________________________ License Plate #: _______________________ State: ______ _________

CLIENT EMPLOYMENT/ CREDIT INFORMA TION

Company Name 1: __________________________________________________________ How Long? _____________
Address: __________________________________________City_________________________ State______ Zip________________
Shift: ________ Duties: ___________________________________________________________ Supervisor: ___________________
Company Name 2: __________________________________________________________ How Long? _____________
Address: __________________________________________City_________________________ State______ Zip________________
Shift: ________ Duties: ___________________________________________________________ Supervisor: ___________________

Name Of Your Bank: _____________________________________________________

          Name                 Relation to Person          Address( City, State, Zip)            Phone Numbers             How Long Known Them?
                                                                                               Home
                                                                                               Cell
                                                                                               Work
                                                                                               Home
                                                                                               Cell
                                                                                               Work
                                                                                               Home
                                                                                               Cell
                                                                                               Work
                                                                                               Home
                                                                                               Cell
                                                                                               Work



         Name Of Your Children                        Age                                          School Attending
1.

2.

3.


     The information written above is true and accurate. I understand that all references given are subject to verif ication via the insurance company.



Signature X________________________________________________ Date __________________



                                                                                                                                                          1
Hunter Payless Bail Bonds
Bondsman: __________________________
NCDOI Permit #: ______________________

PRIMA RY INDEMNITOR INFORMA TION

First: ________________________ Middle: _______________Last: _________________________Nickname: ___________________
Maiden Name(s): ____________________________________SS#________ -______ -_________ DOB_______ / _______ / _______
Address 1:__________________________________________City_________________________ State______ Zip_______________
Address 2:__________________________________________City_________________________ State______ Zip_______________
Resident Type: ______________________________________ How Long? __________________ Land Lord: ___________________
Cell Phone# _________________________ Home Phone# ________________________ Work Phone# ________________________
City of Birth: ___________________________ State of Birth: ________________________ Nationality: ________________________
Marital Status: _______________________________________ Mother’s Maiden Name: ____________________________________
Driver’s License #:_______________________________ State________________ Expiration Date: ___________________________

PRIMA RY INDEMNITOR EMPLOYME NT INFORMA TION
Company Name 1: __________________________________________________________ How Long? ___________ __
Address: __________________________________________City_________________________ State______ Zip________________
Shift: ________ Duties: ___________________________________________________________ Supervisor: ___________________
Company Name 2: __________________________________________________________ How Long? _____________
Address: __________________________________________City_________________________ State______ Zip________________
Shift: ________ Duties: ____________________________________________ _______________ Supervisor: ___________________

PRIMA RY INDEMNITOR AUTOMOB ILE INFORMA TION
Car make: ___________________________________ Car Model: _______________________________ Year: __________________
Color: __________________________________ License Plate #: _______________________ State: _______________

PRIMA RY INDEMNITOR CREDIT INFORMA TION
Name Of Your Bank: _____________________________________________________

                                           REFERE NCES OF PEOP LE NOT LIV ING WITH YOU

          Name                 Relation to Person          Address( City, State, Zip)            Phone Numbers            How Long Known Them?
                                                                                               Home
                                                                                               Cell
                                                                                               Work
                                                                                               Home
                                                                                               Cell
                                                                                               Work
                                                                                               Home
                                                                                               Cell
                                                                                               Work
                                                                                               Home
                                                                                               Cell
                                                                                               Work


INDEMNITY AGREEMENT AND GUARANTY
I,__________________________ in consideration of HUNTER PAYLESS BAIL BONDS acting and being obligated as surety on bail on
_______________________________ in the amount of $________________ do guarantee the payment of said bond to the above named Bail
Bondsman in the event of forfeiture by the above named principal. I specif ically waiv e notice of acceptance of the guaranty, acknow ledge myself as fully
bound by all provisions of the above stated bail bond, and expressly agree to pay, upon demand, any amount ow ing, not to exceed the amount of
forfeiture ordered there under, and I do hereby agree to indemnity and hold harmless the above Bail Bondsman for such amount 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.

GAURANTEE OF PA PERWORK COMPLETION
I, _________________________ understand as the indemnitor (co-signer) for ____________________________ that is my responsibility to make sure
the offic e of HUNTER PAYLESS BAIL BONDS to complete paperwork within 24 hours of his /her release. Failure to do so will w aiv e as unlawful
concealment from the Surety, and the defendant will be surrendered back to the ___________________________ County Jail and NO BOND
PREMIUMS w ill be refunded to the indemnitor.

    The information written above is true and accurate. I understand that all references given are subject to verif ication via the insurance company.



Signature X________________________________________________ Date __________________
                                                                                  2
Hunter Payless Bail Bonds
Bondsman: __________________________
NCDOI Permit #: ______________________

SECONDA RY INDEMNITOR INFORMA TION

First: ________________________ Middle: _______________Last: _________________________Nickname: ___________________
Maiden Name(s): ____________________________________SS#________ -______ -_________ DOB_______ / _______ / _______
Address 1:__________________________________________City_________________________ State______ Zip_______________
Address 2:__________________________________________City_________________________ State______ Zip_______________
Resident Type: ______________________________________ How Long? __________________ Land Lord: ___________________
Cell Phone# _________________________ Home Phone# ________________________ Work Phone# ________________________
City of Birth: ___________________________ State of Birth: ________________________ Nationality: ________________________
Marital Status: _______________________________________ Mother’s Maiden Name: ____________________________________
Driver’s License #:_______________________________ State________________ Expiration Date: ___________________________

SECONDA RY INDEMNITOR EMPLOYME NT INFORMA TION
Company Name 1: __________________________________________________________ How Long? _____________
Address: __________________________________________City_________________________ State______ Zip________________
Shift: ________ Duties: ___________________________________________________________ Supervisor: ___________________
Company Name 2: _______________________________________ ___________________ How Long? _____________
Address: __________________________________________City_________________________ State______ Zip________________
Shift: ________ Duties: ___________________________________________________________ Supervisor: ___________________

SECONDA RY INDEMNITOR AUTOMOB ILE INFORMA TION
Car make: ___________________________________ Car Model: _______________________________ Year: __________________
Color: __________________________________ License Plate #: _______________________ State: _______________

SECONDA RY INDEMNITOR CREDIT INFORMA TION
Name Of Your Bank: _____________________________________________________

                                           REFERE NCES OF PEOP LE NOT LIV ING WITH YOU

          Name                 Relation to Person          Address( City, State, Zip)            Phone Numbers            How Long Known Them?
                                                                                               Home
                                                                                               Cell
                                                                                               Work
                                                                                               Home
                                                                                               Cell
                                                                                               Work
                                                                                               Home
                                                                                               Cell
                                                                                               Work
                                                                                               Home
                                                                                               Cell
                                                                                               Work


INDEMNITY AGREEMENT AND GUARANTY
I,__________________________ in consideration of HUNTER PAYLESS BAIL BONDS acting and being obligated as surety on bail on
_______________________________ in the amount of $________________ do guarantee the payment of said bond to the above named Bail
Bondsman in the event of forfeiture by the above named principal. I specif ically waiv e notice of acceptance of the guaranty, acknow ledge myself as fully
bound by all provisions of the above stated bail bond, and expressly agree to pay, upon demand, any amount ow ing, not to exceed the amount of
forfeiture ordered there under, and I do hereby agree to indemnity and hold harmless the above Bail Bondsman for such amount 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.

GAURANTEE OF PA PERWORK COMPLETION
I, _________________________ understand as the indemnitor (co-signer) for ____________________________ that is my responsibility to make sure
the offic e of HUNTER PAYLESS BAIL BONDS to complete paperwork within 24 hours of his /her release. Failure to do so will w aiv e as unlawful
concealment from the Surety, and the defendant will be surrendered back to the ___________________________ County Jail and NO BOND
PREMIUMS w ill be refunded to the indemnitor.

    The information written above is true and accurate. I understand that all references given are subject to verif ication via the insurance company.



Signature X________________________________________________ Date __________________

                                                                                                                                                          3
HUNTER PAYLESS BAIL BONDS
Bondsman: ___________________________________________________ NCDOI Permit #:_______________________________________

MEMORADUM OF AGREEMENT
The Memorandum of Agreement is between the PRINCPAL, INDEMNITOR, and SURETY when in any case some portion of the
bond premium payments are to be deferred or paid after the defendant has been released from custody pursuant to North Carolina
General Statue 58, Article 71, and Section 167.
1. Amount of the bond premium charged:          $____________________________
2. Amount of the bond premium deferred          $____________________________
3. Method and Schedule of Payment
    A) When w ill the payment be paid:
         Monthly___ Biw eekly___ Weekly___ Daily___
    B) Amount of each payment:
    C) Due date of each payment:
      DATE                                                       AMOUNT




Do not sign this Memorandum of Agreement until after you have read the memorandum thoroughly. Upon the request, your are entitled to a
copy of this agreement. Any subsequent modifications of this agreement must be in writing, signed, dated, and kept on the file by
SURETY’s, w ith a copy provide to the PRINCIAPAL and INDEMINTORS.

This the _______day of _____________, 2007.

                                                       Signature of INDEMNITORS 1:________________________________
Signature of PRINCIPAL: ________________________________Signature of INDEMNITORS 2:_______________________________ _


State of North Carolina
County of __________________________________                                                      In The Count of Common Pleas


Plaintiff
Vs.
Defendant

I/We, the undersigned __________________________________(Indemnitor 1) and __________________________(Indemnitor 2), do
hereby confess to judgment in favor of HUNTER PAYLESS BAIL BONDS for the sum of $ __________________. I/We hereby authoriz e
against me, for the sum of $ __________________, with interest and cost from this date. This Confession of Judgment is secur e a
debt justly owed to HUNTER PAYLESS BAIL BONDS by me under the terms of our Note of executed and delivered by use to Plaintiff on
this date to secure note to HUNTER PAYLESS BAIL BONDS. I do not have an attorney and fully understand the context of this
Confession of Judgment.

Sw orn to before this ____ day of _____________. 2007.

Notary of Public __________________________
My Commission expires on __________________

                                                                                           ____________________________________________
                                                                                                                 Seal



CONTITIONS OF BOND
      1. The Surety, ad bail, shall have control and jurisdiction over the principal during the term for whic h bond is executed and shall have
the right to apprehend, arrest and surrender the principal to the proper officials at any time as provided by law.
      2. In the event surrender of principal is made prior to the time set for the principal’s appearances, and for reason other than as
enumerated below in paragraph 3, then payee shall be entitled to a refund to the bond premium.
      3. It is understood and agreed that the happening of any one of the following events shall constitute a breach of principal’s obligation
 to the SURETY hereunder, and the SURETY shall have the right to forthwith apprehend, arrest and surrender principal, and principal shall
 have no right to any refund or premium whatsoever. Said events whic h shall constitute a breach of principal’s obligation hereunder are:
                a) If the principal shall depart the jurisdiction of the court without the written consent of the cour t and the SURETY or its Agent.
                b) If the principal shall move from one address to another without notif ying the SURETY or its Agent in writing prior to said move
                c) If principal shall commit any act which shall constitute reasonable evidence of principal’s intention to cause a forfeiture of said bond.
                d) If principal is arrested and incarcerated for any other offic es other than a minor traffic violation
                e) If principal shall make any material false statement in the application.
Principal acknow ledgement: I have read and receiv ed a copy of these conditions. I fully understand and agree that any breach of the
conditions listed above may result in surrender.
Indemnitor acknow ledgement: I have read and received a copy of these conditions and understand and agree that should any breach of
the conditions listed above occur, I may request/consent that the principal be surrendered by surety and agree to pay all costs incurred by
Surety as a result of this undertaking. However, I do understand and agree that the Surety has no legal duty to comply w ith said
Request/consent made by indemnitor.                                                   Signature of Indemnitor 1:___________________________________
Signature of Principal:______________________________________________ Signature if Indemnitor 2: ____________________________________
Date: ___________________________________________________________ Date: ____________________________________________________

                                                                                                                                                          4

				
DOCUMENT INFO
Jun Wang Jun Wang Dr
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