Form Ao 100b - Surety Information Sheet - United States District Court

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AO 100B (Rev. 12/09) Surety Information Sheet
U
S
D
C
NITED
TATES
ISTRICT
OURT
for the
__________ District of __________
United States of America
)
v.
)
Case No.
)
)
)
Defendant
SURETY INFORMATION SHEET
(Under Fed. R. Crim. P. 49.1, this form may only be filed in court if redacted or under seal.)
Use a separate information sheet for each surety.
Attach photocopies of two pieces of personal identification, including at least one picture i.d. for each.
Surety information:
Name:
Date of birth:
Social Security No.:
Immigration status:
Alien Registration No.:
Home address:
Home/cell phone No(s).:
Employer’s name:
Employer’s address:
Monthly salary
: $
(gross)
Work phone No.:
Length of employment:
’ months
’ years
Source of additional income
:
(if applicable)
Amount of additional income
:
(if applicable)
Real property owned by surety
:
(if more than one piece of property, please use additional sheets)
Address:
Value: $
Equity in property: $
Are payments/taxes current? ’ Yes
No
Any holders of trust deeds:
Is proof of surety’s title to property attached?
’ Yes
’ No
Appraisal?
AUSA:
Surety:
(initials)
(initials)

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