Form Ao 100a - Bail Information Sheet - United States District Court

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AO 100A (Rev. 01/09) Bail Information Sheet
U
S
D
C
NITED
TATES
ISTRICT
OURT
for the
__________ District of __________
United States of America
)
v.
)
Case No.
)
)
)
Defendant
BAIL INFORMATION SHEET
(Under Fed. R. Crim. P. 49.1, this form may only be filed in court if redacted or under seal.)
Defendant’s 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:
’ months
’ years
Work phone No.:
Length of employment:
Name, address, and phone number of any persons with whom defendant will live during pendency of the case:
Name, address, and phone number of any persons residing in the United States who will know how to contact defendant,
aside from sureties on this bond:
I swear under penalty of perjury that the above information is true.
Defendant’s signature
Defendant’s attorney information:
Name:
Phone(s):
Address:
AUSA:
Defendant’s Attorney:
(initials)
(initials)
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