Form Ao 100b - Surety Information Sheet - United States District Court Page 2
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2AO 100B (Rev. 12/09) Surety Information Sheet (Page 2)
Affidavit by Owner of Cash Security
(Complete if applicable)
I,
, declare that the $
cash deposited
as security on the foregoing bond is owned by me and is to be returned to me at the address listed on page one of this
information sheet upon exoneration of this bond. I subject these funds to the provisions of any applicable local court
rule and agree that in case of default or willful contempt of court on the part of the principal, the court may, upon at least
14 days notice to me, summarily render judgment against the cash security.
Justification of Surety and Surety Agreement
I,
, declare under penalty of perjury, that my net worth is
$
and that I have read and understand this two-page information sheet. I further understand
that by signing the appearance bond and this information sheet, I will be responsible for the defendant’s appearances in
court and the defendant’s compliance with all conditions of release as ordered by the court. If the defendant does not
appear or comply with the conditions of release, I will be required to pay the amount of the bond, any security I have
posted may be taken by the Government, and a judgment may be entered against me. If judgment is entered against me,
a judgment lien will be filed with the county recorder in all appropriate counties for the full amount of the bond.
I declare under penalty of perjury that all information contained in this bond and on this surety information
sheet is true.
Date:
Surety’s signature
Signed before me.
Signature of witness to surety’s signature
Printed name of witness to surety’s signature
Address of witness to surety’s signature
(initials)
(initials)
Defendant’s Attorney:
AUSA:
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