Lawyers Trust Bail Bonds BAIL BOND APPLICATION 8 North Court Street Westminster, Maryland (T) (410) / (F) (410)

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Lawyers Trust Bail Bonds BAIL BOND APPLICATION 8 North Court Street Westminster, Maryland 21157 (T) (410) 871-1750 / (F) (410) 558-6686 AGENT NAME: AGENT PHONE: POWER#: of Execution: Facility being held at: _ Bond Amount: ID#: Case No: Offense: Atty/Tele#: Trial : Court: Defendant Name: Telephone: Email: Address: City: State: Zip: How long at current address: mo/yrs Rent: Own: Other (explain): Previous Address: Years Resided: Race: Sex: MALE FEMALE (circle) Height: Weight: Hair: Eyes: SSN #:_ DOB: Drivers Lic. # Vehicle info: Spouse or Other: Children, Names & Ages: Marks/Features/Tattoos/Glasses: Hangouts Employer Name & Address: Employer Tel #: Defendant s Occupation: _ How long on job: In Consideration of LAWYERS TRUST BAIL BONDS executing or procuring the execution of guaranteeing or continuing the bond described in the foregoing statement, or any renewal thereof, we the undersigned hereby jointly and severally covenant and agree as follows. That we will immediately pay to LAWYERS TRUST BAIL BONDS. as premium for the insurance of said bond, ten percent thereof and a like amount hereafter in advance until we shall serve upon LAWYERS TRUST BAIL BONDS, competent written legal evidence, satisfactory to evidence satisfactory to LAWYERS TRUST BAIL BONDS, of its discharge from such bond renewals, and all liability there under. For service rendered, the undersigned understands by signing this agreement that the fee for our service is 10% of the bail that is to be posted. The undersigned has agreed on this day of _ 20 to make payments of $.00 dollars on a WEEKLY BIWEEKLY MONTHLY as agreed upon herein this agreement until the total remaining balance amount of $.00 is PAID IN FULL. PAYMENT ARRANGEMENT WEEKLY ( ) BIWEEKLY ( ) MONTHLY ( ) NEXT PAYMENT DUE ON: / / of Indemnitor #1 of Defendant of Indemnitor # 2 1

INDEMNITOR INFORMATION (Please write legibly) INDEMNITOR # 1 Relationship to defendant: _ Name: _ Telephone # Email:_ Address: City: State Zip: years Resided Previous Add: Years Resided DOB: Social Security #: Drivers License #: Employer: Employer Address: Employer Tel #: Job Title: Length of Employment: Previous Employer: Vehicle Info: Print Name INDEMNITOR # 2 Relationship to defendant: _ Name: _ Telephone # Email:_ Address: City: State Zip: years Resided Previous Add: Years Resided DOB: Social Security #: Drivers License #: Employer: Employer Address: Employer Tel #: Job Title: Length of Employment: Previous Employer: Vehicle Info: Print Name FOUR REFERENCES: (3 Family References / 1 Friend) #1 Name: Address: Relationship #2 Name: Address: Relationship #3 Name: Address: Relationship #4 Name: Address: Relationship 2

BAIL BOND INDEMNIFICATION AGREEMENT (Read This Document Carefully) :, 20 IN CONSIDERATION OF LAWYERS TRUST BAIL BONDS, its agents, servants and/or employees (hereinafter referred to as Bondsman ) executing, procuring, guaranteeing and/or continuing a bail bond for in the amount of Dollars ($.00), or (Defendant Name) any renewal thereof, we, the undersigned, hereby, jointly and severally, covenant and agree to pay the Bondsman a premium in the amount of Dollars ($.00). Further, the undersigned, jointly and severally, will at all times indemnify and keep the Bondsman indemnified and hold it harmless from and against any and all losses, demands, liabilities and expenses associated with the forfeiture, and/or collection of any outstanding premium, including, but not limited to the following: (a) the principal amount of any forfeiture of the foregoing bail bond, (b) detective fees and fees for any and all agents of the Bondsman to attempt to prevent the forfeiture of the foregoing bail bond, which fees shall be in the amount of thirty percent (30%) of the amount of the bond, (c) reasonable attorney fees in the amount of fifteen percent (15%) of the amount of the bond or unpaid premium, as applicable, (d) all extradition costs that may be incurred to apprehend the party being bonded, and (e) any and all other costs, expenses and/or fines that may be incurred by any forfeiture of the foregoing bail bond. I understand and agree that you, as my bail, shall have the control and jurisdiction of me during the term for which the bond is executed and that you will have the right to surrender me on this bond at any time you may desire. The undersigned fully understands that in the event the defendant should become incarcerated again for any reason that I/We shall remain fully obligated for the above bond payments and any fees if any until the above bond is paid in full. FURTHERMORE, the undersigned, jointly and severally, consent to any and all credit record searches by, and releases of information of their credit reports to the Bondsman. If, in the sole opinion of the Bondsman, the undersigned is obligated to pay any sum or sums of money under this Indemnification Agreement or in the event that forfeiture of the foregoing bail bond, the undersigned hereby authorizes the Bondsman to sue on that/those Note(s) executed by the undersigned on even date herewith for the bond and/or for the balance of premium due. IN WITNESS WHEREOF, the undersigned sets his or her hand and affixes his or her seal on the date and year first above written. (Indemnitor #1 ) (SEAL) (Indemnitor #2 ) (SEAL) (Defendant ) (SEAL) 3

DEMAND PROMISSORY NOTE FOR BAIL BOND FEE/ FORFEITUIRE AMOUNT (Read This Document Carefully) Defendant Name: _ Bond Amount: $. 00 Dollars :, 20 FOR VALUE RECEIVED, the undersigned, jointly and severally if more than one person signs, promises to pay to the order of LAWYERS TRUST BAIL BONDS (hereinafter the Bondsman ), immediately upon demand, the BAIL BOND FEE in the principal sum of Dollars ($.00). FOR VALUE RECEIVED, the undersigned, jointly and severally if more than one person signs promises to pay to the order of LAWYERS TRUST BAIL BONDS (hereinafter the Bondsman ), immediately upon demand, the FORFEITURE AMOUNT principal sum of the entire bond amount of Dollars ($.00). The undersigned shall be in default under this Note upon non-payment when demand for the unpaid balance of the principal sum due under the note is made by the Bondsman. Upon default hereunder, the unpaid balance hereof shall, without further notice or demand, become immediately payable, and the undersigned further agrees to pay and any all costs and expenses, including reasonable attorney s fees in the amount of fifteen (15%) percent, plus court costs, if any, resulting from the enforcement or collection of this Note. The undersigned waives presentment, protest and demand, notice of protest, notice of dishonor, and nonpayment of this Note and expressly agrees that this Note or any payment hereunder maybe extended from time to time, or liability may be extinguished as to one undersigned, without in any way affecting the liability of any other undersigned. AND FURTHER, I/We do hereby empower any Attorney of any Court of Record within the United States or elsewhere to appear for me/us and after one or more declarations filed, confess judgment against me/us as any term for the above sum plus any and all expenses that may be incurred by Lawyers Trust Bail Bonds LLC. in apprehending me/us, with cost of suit and attorney s commission of (Fifteen) 15 percent for collection and release of all errors, and without stay of inquisition and extension upon any levy on real estate as hereby waived and condemnation agreed to and the exemption of personal property from levy and sale on any execution hereon is also expressly waived, and no benefit of exemption be claimed under and by virtue of any exemption law now in force or which may be hereafter passed. (Indemnitor #1 ) (SEAL) (Indemnitor #2 ) (SEAL) (Defendant ) (SEAL) 4

WAIVER Explanation of rights in connection with signing of instrument containing Confession of Judgment as required by opinion of the Supreme Court of the United States The undersigned clearly and specifically understand that by signing the note above referred to, containing a Confession of Judgment clause: 1. We and each of us authorize LAWYERS TRUST BAIL BONDS LLC to enter a judgment against the undersigned, or either of us, at its discretion and in its favor without notice and without declaration of default for non-payment, which entry will give the holder a lien as security for payment upon the real property, including the home, owned by the undersigned at the time of entry, and a lien on personal property owned by the undersigned at the time it is given to the sheriff for execution. 2. All of the undersigned waive all right to notice and to have an opportunity to be heard prior to entry of the judgment on the court records, I understand that the only method to challenge this judgment would be by proceedings in Court to open or strike it, which proceedings would result in substantial attorney s fees which the undersigned would have to pay. Without such clause containing a Confession of Judgment the holder would have to file a suit against the undersigned which would give the undersigned an opportunity for a hearing which the undersigned does not have by reason of the confession. The undersigned acknowledge(s) receipt of a copy of this affidavit and certify that after reading and fully understanding it, the undersigned have signed this affidavit intentionally, understandingly and voluntarily waiving all the above rights, being willing to sign such note despite the consequences set forth above. 5