Ref.
For the Value Received, the undersigned:
Indemnitor(s) and Defendant, joint and severally promise to pay the order of Jim Searcy Bail Bond the sum of :

Dollars, together with interest of 10% per a sum on the unpaid balance. The unpaid principal and any accrued interest shall be fully and immediately payable upon demand of any holder hereof.

As appointed Attorney-In-Fact, the acknowledge agent is authorized to appear for the undersigned in any court and waive the issue and service of process a judgment or judgments against the undersigned jointly or severally at anytime hereafter in favor of the holder for such amount as may appear to be unpaid or declared due and payable hereon together with cost to include but not limited to court cost, pick-up fees, telephone charges, processing fees, and investigative fees.

Upon default the undersigned agrees to pay the full amount of the bond as well as all reasonable legal fees and costs of collection to the extent permitted by the law. This Promissory Note shall effect as a sealed instrument and be enforced in according with the laws of the State of Virginia. All parties to this Promissory Note waive presentment, notice of nonpayment, protest, and notice of protest and agree to remain full bound notwithstanding the release of any party, extension, modification of terms or discharge of any collateral for this note.

Indemnitor #1:
Indemnitor #2:
Defendant:
Agent:
Execution Date of Bond:
Courts:
Received as security for the execution of the bail bond written in the sum of :
on behalf of the defendant:
the following described collateral :

PICK-UP FEES

Simple Pick-Up: Minimum $200     Credit card: $5 per Hundred     Difficult Pick-up: 10% of Bond

Indemnitor Replacement: $300     Out of Town Pick-up: 10% plus expenses     Court Appearance: $125/hr for show causes

*COLLATERAL WILL BE RETUNRED WITHIN 60 DAYS AFTER CASE IS FINALIZED

Money Receipt
Check #:
Bail Bond Premium
Misc. Charges
Total Charges
Amount Paid
Balance Due
Date Balance Due
Receive From

PREMIUM PAID ON BOND IS NOT RETURNABLE

THERE MAYBE ADDITIONAL COST FOR FAILURE TO APPEAR CASES

Credit Card #
Exp. Date
Amount
Signature*

I AUTHORIZE THE CHARGES AS IT RELATES TO THIS BOND.

Street Address
City/State/Zip
Telephone #
Cell Phone #