Hood County Bail Bond Board Agents Application to work for Individual Surety [Pursuant to Texas Occupations Code, Chapter 1704 ( the Code ) and Rules and Regulations of the Hood County Bail Bond Board] Date of Application: Licensee: Agent: Circle One: Original / Renewal / Agent License. (Renewal): License Exp. (Renewal): D/B/A: Documents required at time of submitting application (Renewal applicants omit documents marked with * ) Completed Application Form. $25.00 Filing fee per each Agent, in the form of a cashier s check, certified check, or money order, made payable to the Hood County Bail Bond Board. Photograph (Sheriff s Office can take picture.) Full set of fingerprints (Sheriff s Office can take prints.) * DPS criminal history for applicant/employees (Sheriff s Office will conduct the check). Must have signed release per individual. Authorization for Release of Personal Information executed by applicant using form attached. Any additional pages necessary to provide information required by the code or this application. All required documents must be turned in with this application. incomplete applications will be accepted. Page 1 of 7
Applicant s Name: Date of Birth: Age: Place of Birth: Driver s License or I.D. Card.: Residence Address: S.S.N.: Phone: Name under which business will be conducted: Form of business: Business Street Address: Office Phone (Please list all telephone numbers): Fax Number(s): Cell Phone: Email: Website: Business Mailing Address (If different than street address): Page 2 of 7
1. Are you a resident of Texas? Yes 2. Are you a United States citizen? Yes 3. Are you licensed as a bail bond surety in another county? * If the answer is yes, the following items must be attached to this application: A. A list of each county in which you hold a bail bond surety license; and B. A statement, as of the date of this application, of any final judgments that have been unpaid for more than 31 days and that arose directly or indirectly from a bail bond executed by you as a surety or as an agent for a surety. 4. Have you been denied a license or had a license suspended or revoked in Hood County, Texas, or any other county in Texas in the past 12 months? *If yes, please explain 5. Have you ever been licensed to write bail bonds in Hood County? *If yes, provide the following information for each company operated by the Bonding Agent (please attach additional sheets as necessary): A. Active Bonds 1. How many active bonds do you appear as surety on at this time? 2. What is the total value of those active bonds? 3. On a separate sheet of paper please list all of your active bonds, include criminal cause number, defendant s name, and bond amount. B. Bond Forfeitures 1. On how many, if any, bail bonds, do you appear that are currently in bond forfeiture status? 2. What is the total value of those bonds in bond forfeiture status? 3. On a separate sheet of paper, please list all bonds that are currently in bond Forfeiture status, include criminal cause number, bond forfeiture cause number (if applicable), defendant s name, bond amount, and date of bond forfeiture. Page 3 of 7
C. Unsatisfied Judgments 1. How many, unpaid final judgments do you have against you as surety on a bail bond at this time? 2. What is the total value of these judgments? 3. On a separate sheet of paper, please list all unpaid final judgments, including criminal cause number, bond forfeiture cause number, amount of judgment, and date of judgment. 4. Have you deposited cash, or a supersedeas bond in the amount of any of these final judgments with the court pending a ruling on a timely filed motion for new trial or on appeal? 6. How long have you been engaged in the bail bond business? 7. In the two years prior to the date of this application, do you have at least one year of continuous work experience in the bail bond business? *If yes, please provide the following information (attach additional pages if necessary): Name of Bail Bond Business: Dates of Employment/Operation: Job Title: Address of Bail Bond Business: Phone Number of the Bail Bond Business: Supervisor: 8. In the two years preceding the date of this application, have you completed at least eight (8) hours of continuing legal education in criminal law or bail bond law courses that are approved by the State Bar of Texas and that are offered by an institution of higher education accredited by the state? *If the answer is yes, please provide supporting documentation to verify course attendance/completion. 9. Have you or any of your proposed employees or agents ever been convicted of any misdemeanor involving moral turpitude or any felony offense in any court in this state or any other state or of the federal government, or have any criminal charges of any nature pending? *If the answer is yes, give date, name of person convicted or charged, offense, city and state, and disposition of the case (attach additional pages if necessary): Page 4 of 7
10. Are you involved in any civil litigation at this time, or have you been involved in any civil litigation during the past five (5) years? *If the answer is yes, give details. Page 5 of 7
Applicant affirms that at no time will he/she execute bail bonds in the aggregate to exceed his limits prescribed by Sec. 1704.203 of the Occupations Code. Applicant affirms that in the event that any information (including but not limited to a change of address, telephone number, fax number, email address, website address, and/or the names of the employees working for the bonding agent) on this application form should cease to be true and correct, the corrected information will be provided in writing to the Secretary of the Hood County Bail Bond Board within seven (7) working days of the date that such information changes. I,, Applicant, do declare that I will comply with all provisions of the Texas Occupations Code, Chapter 1704, all other statutes regulating any phase of the bail bonding business in the state and county, and all Rules and Regulations of the Hood County Bail Bond Board. Applicant makes each of the foregoing statements, together with each statement in each enclosure hereto, for the purpose of inducing the Hood County Bail Bond Board, Hood County, Texas, to issue to him/her a license to act as bondsman in the courts of Hood County, Texas, well knowing and understanding that any representation herein and therein which is not true and correct, or any misrepresentation or omission which causes the same not to truly and accurately demonstrate his/her personal and financial responsibility as a licensed bondsman in said courts, may result in the denial of said license, the denial of any renewal thereof, or in the revocation thereof should same be granted under this application. Date Signature of Applicant STATEOF TEXAS COUNTY OF HOOD Before ME, the undersigned authority, a tary Public in and for the State of Texas, on this day personally appeared, known to me to be the person whose name is subscribed to the foregoing instrument and attachments, who having been by me duly sworn, deposes and says that he/she signed the same in the capacity therein expressed, for the purposes and considerations expressed, and, further, that to his/her actual knowledge every statement contained therein together with all enclosures thereto, is true and correct. GIVEN UNDER MY HAND AND SEAL OF OFFICE ON THIS THE day of, 20. tary Public in and for THE STATE OF TEXAS My Commission Expires: Page 6 of 7
HOOD COUNTY BAIL BOND BOARD AUTHORITY FOR RELEASE OF INFORMATION AND WAIVER KNOW ALL MEN BY THESE PRESENTS: I,, do hereby authorize a review of and full disclosure of all records concerning myself to any duly authorized agent of the Hood County Bail Bond Board, whether the said records are of public, private, or confidential nature. THIS AUTHORIZATION IS NOT TO INCLUDE ANY MEDICAL- RELATED HISTORY OR WORKERS COMPENSATION CLAIMS. The intent of this authorization is to give my consent for full and complete disclosure of the records of educational institutions; employment and pre-employment records, including background reports, efficiency ratings, complaints or grievances filed by or against me; and the records and recollections of attorney at law, or other counsel, whether representing me or another person in any case, either criminal or civil, in which I presently have, or have had an interest, excluding any medical malpractice cases or workers compensation claims. I understand that any information obtained by personal history background investigation which is developed directly or indirectly, in whole or in part, upon this release authorization will be considered in determining suitability for licensure by the Hood County Bail Bond Board. I also certify that any person(s) who may furnish such information concerning me shall not be held legally accountable for giving this information in any way; and I do hereby release said person(s) from any and all liability which may be incurred as a result of furnishing such information. A photocopy of this Release form will be valid as an original thereof, even though the said photocopy does not contain an original writing of my signature. Signature (including maiden name) Address City/State/Zip Printed Name Business Phone Phone STATE OF TEXAS * COUNTY OF HOOD * Subscribed and sworn to before me this day of, 20. tary Public, State of Texas My commission expires: Page 7 of 7