SlideShare ist ein Scribd-Unternehmen logo
1 von 1
Downloaden Sie, um offline zu lesen
ROCHE SURETY &
CASUALTY COMPANY, INC.
1910 Orient Road • Tampa, Florida 33619
(813) 623-5042 • (800) 789-3899 • Fax (813) 623-5939
Power No.
Arrest No.
STATE OF FLORIDA
vs.
Court
County
STATE OF FLORIDA
KNOW ALL MEN BY THESE PRESENTS: That we, the above captioned Defendant, as Principal, and ROCHE SURETY & CASUALTY
COMPANY, INC., a Florida Corporation, as Surety, are held and firmly bound unto the Governor of the State of Florida, and his successors, in the penal
sum of $ Dollars, for the payment whereof well and truly to be made we bind
ourselves, our heirs, representatives, successors, and assigns, jointly and severally, firmly by these presents.
The condition of this obligation is such that if the said principal shall appear on at the next
Regular or Special term of the above captioned Court only and shall submit to the said Court to answer a charge of
only and shall submit to orders and process of said Court and not depart same without leave, then
this obligation to be void, else to remain in full force and virtue.
This bond is not valid for pre-sentence investigation, pre-trial intervention or countermeasure program unless specifically authorized by surety.
SIGNED AND SEALED this day of A.D.,
Taken before me and approved by me: (L.S.)
Principal
Sheriff ROCHE SURETY & CASUALTY COMPANY, INC.
By: D.S. (L.S.)
Attorney-in-Fact (Surety)
STATEMENT OF THE BONDSMAN
I, THE UNDERSTATED, AM A DULY LICENSED BAIL BOND AGENT PURSUANT TO Chapter 648, Florida Statutes, or a duly licensed
general lines agent pursuant to Part II of Chapter 626, Florida Statutes, and have registered for the current year with the office of the Sheriff
and Clerk of the Circuit Court of the aforementioned County, and have filed a certified copy of my appointment by Power of Attorney for the
Surety with the office of the Sheriff and Clerk of the Circuit Court of the aforementioned County.
That the Principal named in the foregoing bond, of (Address)
, has
(given or promised to give) the sum of ($ ) Dollars
as consideration for the foregoing bond, filed with the Clerk of the above captioned Court, located in said County, together with the (promise or
receipt) of security belonging to:
of (address):
as follows: (Detail description of collateral security) (If none, so state)
That a duly signed receipt has been given to the said principal for the consideration given and/or that the said indemnitor has (also been) given
a receipt for the security described above.
Agency Agent’s Signature
WHITE – COURT COPY YELLOW AND / OR PINK – AGENT’S COPY
GENERAL SURETY
APPEARANCE BOND
SEND ALL COURT NOTICES TO EXECUTION AGENT’S ADDRESS:
TRANSFER BOND CONTACT:
IN THE
Form FL-1 Rev. 3/06

Weitere ähnliche Inhalte

Was ist angesagt?

Illinois Life and Health Insurance License
Illinois Life and Health Insurance LicenseIllinois Life and Health Insurance License
Illinois Life and Health Insurance LicenseJeffrey E. S. Horowitz
 
Legal correspondence
Legal correspondenceLegal correspondence
Legal correspondenceChris Harden
 
Verification Of Employment Eligibility 2009
Verification Of Employment Eligibility 2009Verification Of Employment Eligibility 2009
Verification Of Employment Eligibility 2009C. Matthew Schulz
 
Take Appointment from Criminal Defense Attorney Jersey City
Take Appointment from Criminal Defense Attorney Jersey CityTake Appointment from Criminal Defense Attorney Jersey City
Take Appointment from Criminal Defense Attorney Jersey CityBruno Ferraro
 
Your attested marriage certificate might not be valid in uae courts
Your attested marriage certificate might not be valid in uae courtsYour attested marriage certificate might not be valid in uae courts
Your attested marriage certificate might not be valid in uae courtsDr. Hassan Mohsen
 
Contract terms and clauses with special meanings
Contract terms and clauses with special  meaningsContract terms and clauses with special  meanings
Contract terms and clauses with special meaningsGettins' Law LLC
 
GreenFin Application Forms
GreenFin Application FormsGreenFin Application Forms
GreenFin Application Formsanna kasutina
 

Was ist angesagt? (13)

Illinois Life and Health Insurance License
Illinois Life and Health Insurance LicenseIllinois Life and Health Insurance License
Illinois Life and Health Insurance License
 
Legal correspondence
Legal correspondenceLegal correspondence
Legal correspondence
 
I Got My Judgement, Now How Do I Get Paid?
I Got My Judgement, Now How Do I Get Paid?I Got My Judgement, Now How Do I Get Paid?
I Got My Judgement, Now How Do I Get Paid?
 
CT License
CT LicenseCT License
CT License
 
Verification Of Employment Eligibility 2009
Verification Of Employment Eligibility 2009Verification Of Employment Eligibility 2009
Verification Of Employment Eligibility 2009
 
Bankruptcy Writing Sample
Bankruptcy Writing SampleBankruptcy Writing Sample
Bankruptcy Writing Sample
 
Have you been charged with shoplifting or Larceny in Raleigh NC?
Have you been charged with shoplifting or Larceny in Raleigh NC?Have you been charged with shoplifting or Larceny in Raleigh NC?
Have you been charged with shoplifting or Larceny in Raleigh NC?
 
Take Appointment from Criminal Defense Attorney Jersey City
Take Appointment from Criminal Defense Attorney Jersey CityTake Appointment from Criminal Defense Attorney Jersey City
Take Appointment from Criminal Defense Attorney Jersey City
 
Application
ApplicationApplication
Application
 
Your attested marriage certificate might not be valid in uae courts
Your attested marriage certificate might not be valid in uae courtsYour attested marriage certificate might not be valid in uae courts
Your attested marriage certificate might not be valid in uae courts
 
Contract terms and clauses with special meanings
Contract terms and clauses with special  meaningsContract terms and clauses with special  meanings
Contract terms and clauses with special meanings
 
Ona application for families dvr 199 e
Ona application for families dvr 199 eOna application for families dvr 199 e
Ona application for families dvr 199 e
 
GreenFin Application Forms
GreenFin Application FormsGreenFin Application Forms
GreenFin Application Forms
 

Ähnlich wie Roche Surety and Casualty Company General Appearance Bond

Power of attorney training
Power of attorney trainingPower of attorney training
Power of attorney trainingMichele Pluta
 
Curtis Funding Application for financing
Curtis Funding Application for financingCurtis Funding Application for financing
Curtis Funding Application for financingCurt MacRae
 
Notice of Breach Default- Sale of Real Property Under Deed of Trust
Notice of Breach Default- Sale of Real Property Under Deed of Trust Notice of Breach Default- Sale of Real Property Under Deed of Trust
Notice of Breach Default- Sale of Real Property Under Deed of Trust cogburnlaw
 
Collecting on Judgments: Levy on Personal Property
Collecting on Judgments: Levy on Personal PropertyCollecting on Judgments: Levy on Personal Property
Collecting on Judgments: Levy on Personal PropertyCynthia Schmidt
 
StacyJonesE-Portfolio Complete
StacyJonesE-Portfolio CompleteStacyJonesE-Portfolio Complete
StacyJonesE-Portfolio CompleteStacy Jones
 
Rochester diocese petition c1
Rochester diocese petition c1Rochester diocese petition c1
Rochester diocese petition c1EileenBuckley
 
How to file a small claims case in san diego
How to file a small claims case in san diegoHow to file a small claims case in san diego
How to file a small claims case in san diegoGreg in SD
 
Sample complaint for rescission of contract in California
Sample complaint for rescission of contract in CaliforniaSample complaint for rescission of contract in California
Sample complaint for rescission of contract in CaliforniaLegalDocsPro
 
St. Louis Divorce: The Basics
St. Louis Divorce: The BasicsSt. Louis Divorce: The Basics
St. Louis Divorce: The BasicsLeigh Carson
 
Application - Curtis Funding Group
Application - Curtis Funding GroupApplication - Curtis Funding Group
Application - Curtis Funding GroupCurt MacRae
 
Fl103.unlocked vietnam
Fl103.unlocked vietnamFl103.unlocked vietnam
Fl103.unlocked vietnamcaudat
 
Sellers affidavit of non foreign status (firpta) (rfrp)
Sellers affidavit of non foreign status (firpta) (rfrp)Sellers affidavit of non foreign status (firpta) (rfrp)
Sellers affidavit of non foreign status (firpta) (rfrp)cdukelow
 

Ähnlich wie Roche Surety and Casualty Company General Appearance Bond (20)

Fl100
Fl100Fl100
Fl100
 
Power of attorney training
Power of attorney trainingPower of attorney training
Power of attorney training
 
Curtis Funding Application for financing
Curtis Funding Application for financingCurtis Funding Application for financing
Curtis Funding Application for financing
 
Notice of Breach Default- Sale of Real Property Under Deed of Trust
Notice of Breach Default- Sale of Real Property Under Deed of Trust Notice of Breach Default- Sale of Real Property Under Deed of Trust
Notice of Breach Default- Sale of Real Property Under Deed of Trust
 
Collecting on Judgments: Levy on Personal Property
Collecting on Judgments: Levy on Personal PropertyCollecting on Judgments: Levy on Personal Property
Collecting on Judgments: Levy on Personal Property
 
Collecting on Judgments: Levy on Personal Property
Collecting on Judgments: Levy on Personal PropertyCollecting on Judgments: Levy on Personal Property
Collecting on Judgments: Levy on Personal Property
 
StacyJonesE-Portfolio Complete
StacyJonesE-Portfolio CompleteStacyJonesE-Portfolio Complete
StacyJonesE-Portfolio Complete
 
POA SAMPLE
POA SAMPLEPOA SAMPLE
POA SAMPLE
 
Dc84
Dc84Dc84
Dc84
 
Dc84
Dc84Dc84
Dc84
 
Rochester diocese petition c1
Rochester diocese petition c1Rochester diocese petition c1
Rochester diocese petition c1
 
How to file a small claims case in san diego
How to file a small claims case in san diegoHow to file a small claims case in san diego
How to file a small claims case in san diego
 
Sample complaint for rescission of contract in California
Sample complaint for rescission of contract in CaliforniaSample complaint for rescission of contract in California
Sample complaint for rescission of contract in California
 
St. Louis Divorce: The Basics
St. Louis Divorce: The BasicsSt. Louis Divorce: The Basics
St. Louis Divorce: The Basics
 
Application - Curtis Funding Group
Application - Curtis Funding GroupApplication - Curtis Funding Group
Application - Curtis Funding Group
 
10000001209
1000000120910000001209
10000001209
 
10000001212
1000000121210000001212
10000001212
 
September 1, 2009
September 1, 2009September 1, 2009
September 1, 2009
 
Fl103.unlocked vietnam
Fl103.unlocked vietnamFl103.unlocked vietnam
Fl103.unlocked vietnam
 
Sellers affidavit of non foreign status (firpta) (rfrp)
Sellers affidavit of non foreign status (firpta) (rfrp)Sellers affidavit of non foreign status (firpta) (rfrp)
Sellers affidavit of non foreign status (firpta) (rfrp)
 

Kürzlich hochgeladen

COPYRIGHTS - PPT 01.12.2023 part- 2.pptx
COPYRIGHTS - PPT 01.12.2023 part- 2.pptxCOPYRIGHTS - PPT 01.12.2023 part- 2.pptx
COPYRIGHTS - PPT 01.12.2023 part- 2.pptxRRR Chambers
 
LITERAL RULE OF INTERPRETATION - PRIMARY RULE
LITERAL RULE OF INTERPRETATION - PRIMARY RULELITERAL RULE OF INTERPRETATION - PRIMARY RULE
LITERAL RULE OF INTERPRETATION - PRIMARY RULEsreeramsaipranitha
 
Appeal and Revision in Income Tax Act.pdf
Appeal and Revision in Income Tax Act.pdfAppeal and Revision in Income Tax Act.pdf
Appeal and Revision in Income Tax Act.pdfPoojaGadiya1
 
How do cyber crime lawyers in Mumbai collaborate with law enforcement agencie...
How do cyber crime lawyers in Mumbai collaborate with law enforcement agencie...How do cyber crime lawyers in Mumbai collaborate with law enforcement agencie...
How do cyber crime lawyers in Mumbai collaborate with law enforcement agencie...Finlaw Associates
 
The Active Management Value Ratio: The New Science of Benchmarking Investment...
The Active Management Value Ratio: The New Science of Benchmarking Investment...The Active Management Value Ratio: The New Science of Benchmarking Investment...
The Active Management Value Ratio: The New Science of Benchmarking Investment...James Watkins, III JD CFP®
 
Audience profile - SF.pptxxxxxxxxxxxxxxxxxxxxxxxxxxx
Audience profile - SF.pptxxxxxxxxxxxxxxxxxxxxxxxxxxxAudience profile - SF.pptxxxxxxxxxxxxxxxxxxxxxxxxxxx
Audience profile - SF.pptxxxxxxxxxxxxxxxxxxxxxxxxxxxMollyBrown86
 
The doctrine of harmonious construction under Interpretation of statute
The doctrine of harmonious construction under Interpretation of statuteThe doctrine of harmonious construction under Interpretation of statute
The doctrine of harmonious construction under Interpretation of statuteDeepikaK245113
 
A SHORT HISTORY OF LIBERTY'S PROGREE THROUGH HE EIGHTEENTH CENTURY
A SHORT HISTORY OF LIBERTY'S PROGREE THROUGH HE EIGHTEENTH CENTURYA SHORT HISTORY OF LIBERTY'S PROGREE THROUGH HE EIGHTEENTH CENTURY
A SHORT HISTORY OF LIBERTY'S PROGREE THROUGH HE EIGHTEENTH CENTURYJulian Scutts
 
一比一原版利兹大学毕业证学位证书
一比一原版利兹大学毕业证学位证书一比一原版利兹大学毕业证学位证书
一比一原版利兹大学毕业证学位证书E LSS
 
一比一原版(QUT毕业证书)昆士兰科技大学毕业证如何办理
一比一原版(QUT毕业证书)昆士兰科技大学毕业证如何办理一比一原版(QUT毕业证书)昆士兰科技大学毕业证如何办理
一比一原版(QUT毕业证书)昆士兰科技大学毕业证如何办理bd2c5966a56d
 
一比一原版(UC毕业证书)堪培拉大学毕业证如何办理
一比一原版(UC毕业证书)堪培拉大学毕业证如何办理一比一原版(UC毕业证书)堪培拉大学毕业证如何办理
一比一原版(UC毕业证书)堪培拉大学毕业证如何办理bd2c5966a56d
 
$ Love Spells^ 💎 (310) 882-6330 in Utah, UT | Psychic Reading Best Black Magi...
$ Love Spells^ 💎 (310) 882-6330 in Utah, UT | Psychic Reading Best Black Magi...$ Love Spells^ 💎 (310) 882-6330 in Utah, UT | Psychic Reading Best Black Magi...
$ Love Spells^ 💎 (310) 882-6330 in Utah, UT | Psychic Reading Best Black Magi...PsychicRuben LoveSpells
 
Presentation on Corporate SOCIAL RESPONSIBILITY- PPT.pptx
Presentation on Corporate SOCIAL RESPONSIBILITY- PPT.pptxPresentation on Corporate SOCIAL RESPONSIBILITY- PPT.pptx
Presentation on Corporate SOCIAL RESPONSIBILITY- PPT.pptxRRR Chambers
 
Municipal-Council-Ratlam-vs-Vardi-Chand-A-Landmark-Writ-Case.pptx
Municipal-Council-Ratlam-vs-Vardi-Chand-A-Landmark-Writ-Case.pptxMunicipal-Council-Ratlam-vs-Vardi-Chand-A-Landmark-Writ-Case.pptx
Municipal-Council-Ratlam-vs-Vardi-Chand-A-Landmark-Writ-Case.pptxSHIVAMGUPTA671167
 
Independent Call Girls Pune | 8005736733 Independent Escorts & Dating Escorts...
Independent Call Girls Pune | 8005736733 Independent Escorts & Dating Escorts...Independent Call Girls Pune | 8005736733 Independent Escorts & Dating Escorts...
Independent Call Girls Pune | 8005736733 Independent Escorts & Dating Escorts...SUHANI PANDEY
 
Chp 1- Contract and its kinds-business law .ppt
Chp 1- Contract and its kinds-business law .pptChp 1- Contract and its kinds-business law .ppt
Chp 1- Contract and its kinds-business law .pptzainabbkhaleeq123
 
BPA GROUP 7 - DARIO VS. MISON REPORTING.pdf
BPA GROUP 7 - DARIO VS. MISON REPORTING.pdfBPA GROUP 7 - DARIO VS. MISON REPORTING.pdf
BPA GROUP 7 - DARIO VS. MISON REPORTING.pdflaysamaeguardiano
 
Philippine FIRE CODE REVIEWER for Architecture Board Exam Takers
Philippine FIRE CODE REVIEWER for Architecture Board Exam TakersPhilippine FIRE CODE REVIEWER for Architecture Board Exam Takers
Philippine FIRE CODE REVIEWER for Architecture Board Exam TakersJillianAsdala
 
MOCK GENERAL MEETINGS (SS-2)- PPT- Part 2.pptx
MOCK GENERAL MEETINGS (SS-2)- PPT- Part 2.pptxMOCK GENERAL MEETINGS (SS-2)- PPT- Part 2.pptx
MOCK GENERAL MEETINGS (SS-2)- PPT- Part 2.pptxRRR Chambers
 

Kürzlich hochgeladen (20)

COPYRIGHTS - PPT 01.12.2023 part- 2.pptx
COPYRIGHTS - PPT 01.12.2023 part- 2.pptxCOPYRIGHTS - PPT 01.12.2023 part- 2.pptx
COPYRIGHTS - PPT 01.12.2023 part- 2.pptx
 
LITERAL RULE OF INTERPRETATION - PRIMARY RULE
LITERAL RULE OF INTERPRETATION - PRIMARY RULELITERAL RULE OF INTERPRETATION - PRIMARY RULE
LITERAL RULE OF INTERPRETATION - PRIMARY RULE
 
Appeal and Revision in Income Tax Act.pdf
Appeal and Revision in Income Tax Act.pdfAppeal and Revision in Income Tax Act.pdf
Appeal and Revision in Income Tax Act.pdf
 
How do cyber crime lawyers in Mumbai collaborate with law enforcement agencie...
How do cyber crime lawyers in Mumbai collaborate with law enforcement agencie...How do cyber crime lawyers in Mumbai collaborate with law enforcement agencie...
How do cyber crime lawyers in Mumbai collaborate with law enforcement agencie...
 
The Active Management Value Ratio: The New Science of Benchmarking Investment...
The Active Management Value Ratio: The New Science of Benchmarking Investment...The Active Management Value Ratio: The New Science of Benchmarking Investment...
The Active Management Value Ratio: The New Science of Benchmarking Investment...
 
Audience profile - SF.pptxxxxxxxxxxxxxxxxxxxxxxxxxxx
Audience profile - SF.pptxxxxxxxxxxxxxxxxxxxxxxxxxxxAudience profile - SF.pptxxxxxxxxxxxxxxxxxxxxxxxxxxx
Audience profile - SF.pptxxxxxxxxxxxxxxxxxxxxxxxxxxx
 
The doctrine of harmonious construction under Interpretation of statute
The doctrine of harmonious construction under Interpretation of statuteThe doctrine of harmonious construction under Interpretation of statute
The doctrine of harmonious construction under Interpretation of statute
 
A SHORT HISTORY OF LIBERTY'S PROGREE THROUGH HE EIGHTEENTH CENTURY
A SHORT HISTORY OF LIBERTY'S PROGREE THROUGH HE EIGHTEENTH CENTURYA SHORT HISTORY OF LIBERTY'S PROGREE THROUGH HE EIGHTEENTH CENTURY
A SHORT HISTORY OF LIBERTY'S PROGREE THROUGH HE EIGHTEENTH CENTURY
 
一比一原版利兹大学毕业证学位证书
一比一原版利兹大学毕业证学位证书一比一原版利兹大学毕业证学位证书
一比一原版利兹大学毕业证学位证书
 
一比一原版(QUT毕业证书)昆士兰科技大学毕业证如何办理
一比一原版(QUT毕业证书)昆士兰科技大学毕业证如何办理一比一原版(QUT毕业证书)昆士兰科技大学毕业证如何办理
一比一原版(QUT毕业证书)昆士兰科技大学毕业证如何办理
 
Sensual Moments: +91 9999965857 Independent Call Girls Vasundhara Delhi {{ Mo...
Sensual Moments: +91 9999965857 Independent Call Girls Vasundhara Delhi {{ Mo...Sensual Moments: +91 9999965857 Independent Call Girls Vasundhara Delhi {{ Mo...
Sensual Moments: +91 9999965857 Independent Call Girls Vasundhara Delhi {{ Mo...
 
一比一原版(UC毕业证书)堪培拉大学毕业证如何办理
一比一原版(UC毕业证书)堪培拉大学毕业证如何办理一比一原版(UC毕业证书)堪培拉大学毕业证如何办理
一比一原版(UC毕业证书)堪培拉大学毕业证如何办理
 
$ Love Spells^ 💎 (310) 882-6330 in Utah, UT | Psychic Reading Best Black Magi...
$ Love Spells^ 💎 (310) 882-6330 in Utah, UT | Psychic Reading Best Black Magi...$ Love Spells^ 💎 (310) 882-6330 in Utah, UT | Psychic Reading Best Black Magi...
$ Love Spells^ 💎 (310) 882-6330 in Utah, UT | Psychic Reading Best Black Magi...
 
Presentation on Corporate SOCIAL RESPONSIBILITY- PPT.pptx
Presentation on Corporate SOCIAL RESPONSIBILITY- PPT.pptxPresentation on Corporate SOCIAL RESPONSIBILITY- PPT.pptx
Presentation on Corporate SOCIAL RESPONSIBILITY- PPT.pptx
 
Municipal-Council-Ratlam-vs-Vardi-Chand-A-Landmark-Writ-Case.pptx
Municipal-Council-Ratlam-vs-Vardi-Chand-A-Landmark-Writ-Case.pptxMunicipal-Council-Ratlam-vs-Vardi-Chand-A-Landmark-Writ-Case.pptx
Municipal-Council-Ratlam-vs-Vardi-Chand-A-Landmark-Writ-Case.pptx
 
Independent Call Girls Pune | 8005736733 Independent Escorts & Dating Escorts...
Independent Call Girls Pune | 8005736733 Independent Escorts & Dating Escorts...Independent Call Girls Pune | 8005736733 Independent Escorts & Dating Escorts...
Independent Call Girls Pune | 8005736733 Independent Escorts & Dating Escorts...
 
Chp 1- Contract and its kinds-business law .ppt
Chp 1- Contract and its kinds-business law .pptChp 1- Contract and its kinds-business law .ppt
Chp 1- Contract and its kinds-business law .ppt
 
BPA GROUP 7 - DARIO VS. MISON REPORTING.pdf
BPA GROUP 7 - DARIO VS. MISON REPORTING.pdfBPA GROUP 7 - DARIO VS. MISON REPORTING.pdf
BPA GROUP 7 - DARIO VS. MISON REPORTING.pdf
 
Philippine FIRE CODE REVIEWER for Architecture Board Exam Takers
Philippine FIRE CODE REVIEWER for Architecture Board Exam TakersPhilippine FIRE CODE REVIEWER for Architecture Board Exam Takers
Philippine FIRE CODE REVIEWER for Architecture Board Exam Takers
 
MOCK GENERAL MEETINGS (SS-2)- PPT- Part 2.pptx
MOCK GENERAL MEETINGS (SS-2)- PPT- Part 2.pptxMOCK GENERAL MEETINGS (SS-2)- PPT- Part 2.pptx
MOCK GENERAL MEETINGS (SS-2)- PPT- Part 2.pptx
 

Roche Surety and Casualty Company General Appearance Bond

  • 1. ROCHE SURETY & CASUALTY COMPANY, INC. 1910 Orient Road • Tampa, Florida 33619 (813) 623-5042 • (800) 789-3899 • Fax (813) 623-5939 Power No. Arrest No. STATE OF FLORIDA vs. Court County STATE OF FLORIDA KNOW ALL MEN BY THESE PRESENTS: That we, the above captioned Defendant, as Principal, and ROCHE SURETY & CASUALTY COMPANY, INC., a Florida Corporation, as Surety, are held and firmly bound unto the Governor of the State of Florida, and his successors, in the penal sum of $ Dollars, for the payment whereof well and truly to be made we bind ourselves, our heirs, representatives, successors, and assigns, jointly and severally, firmly by these presents. The condition of this obligation is such that if the said principal shall appear on at the next Regular or Special term of the above captioned Court only and shall submit to the said Court to answer a charge of only and shall submit to orders and process of said Court and not depart same without leave, then this obligation to be void, else to remain in full force and virtue. This bond is not valid for pre-sentence investigation, pre-trial intervention or countermeasure program unless specifically authorized by surety. SIGNED AND SEALED this day of A.D., Taken before me and approved by me: (L.S.) Principal Sheriff ROCHE SURETY & CASUALTY COMPANY, INC. By: D.S. (L.S.) Attorney-in-Fact (Surety) STATEMENT OF THE BONDSMAN I, THE UNDERSTATED, AM A DULY LICENSED BAIL BOND AGENT PURSUANT TO Chapter 648, Florida Statutes, or a duly licensed general lines agent pursuant to Part II of Chapter 626, Florida Statutes, and have registered for the current year with the office of the Sheriff and Clerk of the Circuit Court of the aforementioned County, and have filed a certified copy of my appointment by Power of Attorney for the Surety with the office of the Sheriff and Clerk of the Circuit Court of the aforementioned County. That the Principal named in the foregoing bond, of (Address) , has (given or promised to give) the sum of ($ ) Dollars as consideration for the foregoing bond, filed with the Clerk of the above captioned Court, located in said County, together with the (promise or receipt) of security belonging to: of (address): as follows: (Detail description of collateral security) (If none, so state) That a duly signed receipt has been given to the said principal for the consideration given and/or that the said indemnitor has (also been) given a receipt for the security described above. Agency Agent’s Signature WHITE – COURT COPY YELLOW AND / OR PINK – AGENT’S COPY GENERAL SURETY APPEARANCE BOND SEND ALL COURT NOTICES TO EXECUTION AGENT’S ADDRESS: TRANSFER BOND CONTACT: IN THE Form FL-1 Rev. 3/06