Affidavit Of Surrender Of Defendant By Surety
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1STATE OF SOUTH CAROLINA,
)
IN THE COURT OF __________________________________
)
COUNTY/MUNICIPALITY OF ________________ )
)
AFFIDAVIT OF SURRENDER OF
)
DEFENDANT BY SURETY
STATE OF SOUTH CAROLINA
)
)
Amount of Bond: ____________
vs.
)
S.S.N.: _____________________
)
D.O.B.: ____________________
)
By: _______________________
Defendant.
)
Date of Bond: _______________
)
IN RE: ______________________________________
)
Surety
)
PERSONALLY APPEARED BEFORE ME, the undersigned surety/deponent, who being duly sworn, states that he is a
duly authorized representative of ______________________________________ Surety Company, who is contractually
acting as surety for the above named defendant on the following
ticket
warrant
indictment number(s) and
charges:__________________________________________________________________________________________
________________________________________________________________________________________________.
Defendant was incarcerated by surety/deponent for a violation or imminent violation of a specific term(s) of the bail
bond as sworn to below. Surety/deponent states under penalty of perjury that the information contained in this
Affidavit constitutes good cause for the immediate incarceration of defendant.
Defendant was incarcerated by
surety/deponent
law enforcement as the result of a bench warrant for a
violation of a specific term(s) of the bail bond as stated in the bench warrant and sworn to below.
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
(Attach additional sheets if necessary.)
Sworn to and Subscribed before me
)
this
day of
, 2
.
)
)
Signature of Surety/Deponent
Notary Public for South Carolina
)
My Commission expires
)
Surety Company
I have received custody of the above named defendant pursuant to
immediate incarceration by surety
bench
warrant and the defendant will remain in custody until such time as notice concerning defendant is received from a
clerk of court or court of competent jurisdiction.
Officer: ____________________________________ Date: _____________________________________________
Detention Facility for the:
County
Municipality of _______________________________
SCCA/636 (07/2008)
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