General Information Form

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Indemnitor Last Name
Indemnitor First Name
Indemnitor Middle Initial
D.O.B.
Indemnitor Social Sec. Number
Relation to defendant
Indemnitor Street Address (apt or suite)
Zip Code
City and State
Indemnitor Phone
Indemnitor Email
Indemnitor Occupation
Indemnitor Employer
Indemnitor Employer Phone
Indemnitor Employer Address
Indemnitor Employer City State Zip
Defendant First Name
Defendant Last Name
Defendant's Middle Initial
Defendant D.O.B. dd/mm/yyyy
Defendant Phone
Defendant Email
Defendant Street Address (apt or suite)
Defendant City and State
Defendant Zip Code
Defendant Employer Phone
BOND NYSID
Docket#
Bail Set Date (dd/mm/yyyy)
Judge Who Set Bail
Part
Charges
Next Court Day (dd/mm/yyyy)
Part
Surety Hold? (yes or no)
Rikers? (yes or no)
Bond
Premium