Collateral Receipt

Collateral Receipt Date: Received From: Address: Home Phone: Receipt No. SSN: Work Phone: Cell Phone: The aforementioned individual has deposited the following collateral as security for the execution of the bail bond: Monetary Collateral Cash in the amount of: $ Money order in the amount of: $ Collateral Documents Indemnity Agreement Other: The aforementioned collateral has been put down as security for the bail bond for the following: Defendant: Offense(s): Court: Bond Amount: $ Power No. Received by: I, the depositor, understand that the collateral will be returned to me once the bond has been discharged and exonerated. Promissory Note Mortgage Deed and Promissory Note Check in the amount of: $ Depositor Signature Date Signed Receipt for Return of Collateral Depositor: Date: I, the depositor, have received the following monetary amounts, collateral documents, or items: $ Collateral Documents: Other Items: Received by: American LegalNet, Inc. www.FormsWorkFlow.com