Defendants and Indemnitor’s Agreement and Guarantee

1 Indemnitor One Information

2 Indemnitor Two Information

3 Bankers Insurance Company

4 Required Signatures

Big Mike Bail Bonds - 134 S. Third St. - Smithfield, NC 27577 - (919) 934-5656
Indemnitor 1
Name*
First Last Relationship To Defendant Nick Name
Spouse or Partner's Name
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date you started living at above address*
MM
DD
YYYY
Status of Homeownership*
- Own
- Buy
- Rent
- Other
Home Phone Number*
Best Number to be Reached
Cell Phone Number*
Date of Birth*
MM
DD
YYYY
SSN*
Employer Name*
Employer Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Job Title*
Work Phone Number*
Time at Current Job*
Shift/Work Hours*
Duties at Job/ Job Description*
Drivers License*
State*
State
Vehicle Year*
Vehicle Model*
Vehicle Color*
Second Idemnitor?*

Indemnitor 2
Name*
First Last Relationship To Defendant Nick Name
Spouse or Partner's Name
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date you started living at above address*
MM
DD
YYYY
Status of Homeownership*
- Own
- Buy
- Rent
- Other
Home Phone Number*
Best Number to be Reached
Cell Phone Number*
Date of Birth*
MM
DD
YYYY
SSN*
Employer Name*
Employer Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Job Title*
Work Phone Number*
Time at Current Job*
Shift/Work Hours*
Duties at Job/ Job Description*
License Number*
State*
State
Vehicle Year*
Vehicle Model*
Vehicle Color*

Big Mike Bail Bonds - 134 S. Third St. - Smithfield, NC 27577 - (919) 934-5656
Bankers Insurance Company
DEFENDANTS AND INDEMNITOR'S INDEMNITY AGREEMENT AND GUARANTEE (You are assigning specific obligations - Please Read Carefully!!)
Location
State Of:
County Of
County Of:
I,*
Defendant (Full Name), and Indemnitor 1 (Full Name), and Indemnitor 2 (Full Name),
in consideration of Big Mike Bail Bonds Inc. / Michael Sinclair (surety) &/or Bankers Insurance companies that's represented by the above name surety are acting and being obligated as surety on a bail bond for defendant as principal, in the amount of
I,*
Defendant (Full Name), and Indemnitor 1 (Full Name),
in consideration of Big Mike Bail Bonds Inc. / Michael Sinclair (surety) &/or Bankers Insurance companies that's represented by the above name surety are acting and being obligated as surety on a bail bond for defendant as principal, in the amount of
Amount $
, do guarantee the payment of said to the above named surety in the event of forfeiture by the above named principal I specifically waive notice of acceptance of this guaranty, acknowledge my self as fully bound by all provisions of the above stated bail bond, and expressly agree to pay, upon demand, any amount owing, not to exceed the amount of forfeiture ordered there under, and I do hereby such forfeiture. This agreement is voided upon termination of liability on the bail bond. I furthermore understand that all collateral deposited with the bondsman will be forfeit upon the principals failure to appear. The agreement becomes void upon termination of liability on the bail bondsman as provided by N.C.G.S. 58-71-5 and N.C. ADMINISTRATIVE CODE .0512. It is further agreed that you can and will be arrested and returned to jail, without a refund on your bond fee, for any of the following reasons: 1. Failure to appear for any court date 2. Changing your address without notifying us 3. Concealing yourself from us 4. Leaving the jurisdiction of the court without our permission 5. Failure to pay the entire bond fee as agreed 6. Knowingly provides incorrect personal ID or uses a false name or alias 7. Fails to disclose any criminal activity, charges or convictions or provides false information regarding any past or current criminal activity charges or convictions.
In Witness hereof , signed, this (date)
MM
DD
YYYY

Required Signatures
I have agreed to submit this application by electronic means. By signing this document electronically, I certify that my answers are correct and complete to the best of my knowledge. I understand that an electronic signature has the same legal effect and can be enforced the same way as a written signature.
Step 1. Check the boxes below showing you have read and understand the - electronic signature agreement above.*
- Defendant
- Indemnitor 1
- Indemnitor 2
Step 1. Check the boxes below showing you have read and understand the - electronic signature agreement above.*
- Defendant
- Indemnitor 1
Defendant's Electronic Signature
Prefix First Middle Last
Indemnitor 1 Electronic Signature
Prefix First Middle Last
Indemnitor 2 Electronic Signature
Prefix First Middle Last

Defendants and Indemnitor’s Agreement and Guarantee

Call Big Mike Bail Bonds Today

919-934-5656

Big Mike Bail Bonds - 134 S. Third St. - Smithfield, NC 27577 - (919) 934-5656

Indemnitor 1

Indemnitor 2

Big Mike Bail Bonds - 134 S. Third St. - Smithfield, NC 27577 - (919) 934-5656

Bankers Insurance Company

Required Signatures