List of Outstanding Bonds

9-305.

STATE OF NEW CITY OF ________________________

IN THE ______________________________ COURT

CITY OF __________________

v. No._____________

______________________________

Defendant

LIST OF OUTSTANDING BONDS, ENCUMBRANCES AND CLAIMS

Note: This list must be kept current and submitted when any bond is filed in District, Magistrate, Metropolitan and Municipal Courts.

1. Property bondsman's name: ____________________________________________

2. License number: ____________________________________________________

3. Bondsman's business address:

_____________________________________________________________________

(Street) (City) (State) (Zip Code)

4. Date of this list: _____________________________________________________

5. Legal description of property securing bond (may be attached):

_____________________________________________________________________

6. Outstanding encumbrances and claims, other than bonds, against property:

_____________________________________________________________________

7. Current outstanding bonds written against property.

Amount Name and Location Date Case Name of

of Bond of Court Posted Number Defendant

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I HEREBY CERTIFY UNDER PENALTY OF PERJURY that the above information is true and correct as of the above date.

_______________________________________________________________

Property Bondsman