Defendant Packet

Release Information

I do hereby authorize Johnnie M. Dishongh Bail Bonds / Affordable Bail Bonds or it’s investigators to gather any information that is needs should this bond be forfeited.

This will include but not exclude:

Credit reports, Marriage, and Divorce records, Employment History, Credit Card Records, Phone Records, and any other information that may be needed by the bonding company or its investigators to locate and arrest the defendant on this bond.
I also authorize the Bond Company Investigators to enter and search any residence listed on this bond belonging to the defendant and or the co-signer.
I also agree to hold harmless the Bond Company and the investigators who have to search for the person who forfeits this bond.

This release of information is made without duress and is understood by the person named above and consent is given willingly.

Defendant's Financial Statement

Last Name *

First Name *

Maiden Name and/or Nick Names *

Cell Phone *

Other Phone

Email *

Height *

Weight *

Hair Color *

Eyes *

Body Type *

Date Of Birth *

Age *

Race *

Sex *

Male

Female

Social Security *

DL/ID Number

State *

Are You A U.S. Citizen? *

Place of Birth *

Home Town City *

How Long Have You Lived In The Area? *

Describe Tattoos, Scars, and/or any Identifying Marks. *

Street Address, Apt#, City, State, and ZIP *

How Long Have You Lived There? *

Living Situation *

Home

Mobile Home

Apartments

Tiny House

Ownership *

Rent

Buying (Mortgage/Payments)

Own Outright

Name of Landloard *

Name of Apartment

Mother's Name *

Mother's Phone Number *

Mother's Address *

Father's Name *

Father's Phone Number *

Father's Address *

Sibling Name *

Sibling Phone Number *

Sibling Address *

Name of Closest Friend *

Friend's Address *

Friend's Date of Birth *

Friend's Phone Number *

Friend's Employer *

Are you on Bond with another company? *

Yes

Select only 1

Employment Information

Name of Employer *

Occupation *

Company Phone Number *

Address *

How long have you been employed with them? *

Monthly Salary *

Spouse's / Common Law Information

Fill out to the best of your ability, if the questions do not concern you please enter in N/A (not applicable)

Spouse Last Name *

Spouse First Name *

Phone *

Current Status *

Married

Single

Separated

Divorced

Select only 1

How Long? *

How Many Children?

Date of Birth *

Employer *

Occupation *

Employer Phone Number *

Automobile Information

Who's Name Is The Car In? *

Make *

Model *

Year *

Color *

2 or 4 door? *

2 Door

4 Door

N/A

License Plate # *

State vehicle is registered in *

Is it financed? *

Yes or No

Finance Company *

Bank / Financial Information

Name of Bank *

Location of branch where account was opened *

List of Properties Owned or Being Purchased By You *

Personal References

Last Name *

First Name *

Relationship *

How Long Known? *

Cell Phone *

Home Phone

Street Address, Apt #, City, State, Zip *

Last Name *

First Name *

Relationship *

How Long Known? *

Cell Phone *

Home Phone

Street Address, Apt #, City, State, Zip *

Full Name *

If you are human, leave this field blank.

PLEASE FILL OUT THE INFORMATION BELOW

Release Information

Defendant's Financial Statement

Employment Information

Spouse's / Common Law Information

Automobile Information

Bank / Financial Information

Personal References