Application For Remission Of Forfeiture Form - Florida Criminal Division Page 2

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6.
A Final Judgment of Forfeiture:
Has not been entered in this case.
Was entered on ____________________ ____, 20____, and the Judgment was set
aside by order of the court on ____________________ ____, 20____, a copy of
which is attached hereto as Exhibit “____.”
7.
$ __________ costs have been expended by Hillsborough County in the surrender
of the defendant as per the documentation from the Hillsborough County Sheriff’s Office
attached hereto as Exhibit “____.”
8.
Pursuant to section 903.28, Florida Statutes, the bail agent is seeking remission of
funds up to ____ % of the bond as the defendant was arrested within ____ days from the date of
forfeiture.
9.
Petitioner asserts that this Application for Remission for Forfeiture is being filed
within two years from the date of forfeiture and that there has been no breach of the bond.
WHEREFORE, petitioner applies for remission of forfeiture and requests this court to
enter an Order granting remission of forfeiture on the condition that all costs shall be paid by the
petitioner.
Dated: _______________
____________________________________
Attorney Signature
Printed Name: _______________________
Address: ____________________________
City, State, Zip: ______________________
Telephone: __________________________
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that the foregoing document has been furnished to State Attorney’s
Office, Hillsborough County Courthouse Annex, 800 East Kennedy Blvd., Tampa, Florida
33602, and Clerk’s Legal Counsel at P.O. Box 1110, 601 East Kennedy Boulevard, 13
th
Floor,
Tampa, Florida 33601, through the e-filing portal by e-service on this the
___ day
of
_________, 20____.
____________________________________
Attorney Signature
2

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