Fayette Bonding
Defendant Contract
Directions: Fill out form completely. If line item in unknown you may need to type "Unknow" if the question is required.
Choose One
Probation/Parole Officer: Attorney:
Defendants Name:
Date:
Case#:
Bond: Fee:
Other Charges Pending:
Felony/Misd:
Legal Name: Nickname:
Social Security Number: Date of Birth:
Email: Facebook:
Address: Length at Residents:
Home: Cell:
Previous Address:
Race: Sex:
Height: Weight: Eyes: Hair:
Tattoos:
Driver License: State Issued:
Vehicle:
Employer:
Employer Address:
Employer Phone Number:
Length at Job: Position: Supervisor:
List References with Address and Phone numbers (Other then Mother, Father, or Co-Signer) All references must be at least 18 years old.
Reference #1
Name: Phone Number:
Relationship to Defendant: Years Known:
Address: City State: Zip Code:
Reference #2
Name: Phone Number
Relationship to Defendant: Years Knows:
Address: City: State: Zip Code:
Reference #3
Name: Phone Number:
Relationship to Defendant: Years Known:
Address: City: State: Zip Code:
Reference #4
Name: Phone Number:
Relationship to Defendant: Years Known:
Address: City: State: Zip Code:
Reference #5
Name: Phone Number:
Relationship to Defendant: Years Known:
Address: City: State: Zip:
Defendant's Parents
Mother's Name: Phone Number:
Email:
Address:
Father's Name: Phone Number:
Email:
Address:
Defendant's Children
1st Child's Name: Phone Number:
Age: Who do they live with?:
Address if other then your own:
2nd Child's Name: Phone Number:
Age: Who do they live with?:
Address if other then your own:
3rd Child's Name: Phone Number:
Age: Who do they live with?:
Address if other then your own:
Failure to Notify Fayette Bonding, of any change of address and or phone will automatically revoke my bond. If I am not present in court on any and all court dates, I will pay all expenses accrued by Fayette Bonding from said revocation. I understand that there will be no refund if it becomes necessary for Fayette Bonding to revoke bond. I further understand that any false information will result in my bond being revoked by Fayette Bonding, Inc. and that I forfeit any and all money paid.
Extradition Waiver
I have been duly informed of my rights to demand and secure legal counsel to test the legality of my arrest through habeas corpus proceedings and to the issuance and service of a warrant of extradition, and do hereby voluntarily and of my own free will, without any threats, promises, undeu justice, or coercion of any kind of nature, waive my rights to extradition from any state in the United States of America or any foreign country, to the State of Georgia, county of and consent to return to the State of Georgia, County of in the custody of Fayette Bonding, or a Georgia law enforcement agency to answer to the charge(s) which have been brought against me.
June 12, 2026
Bail Agent Signature:______________________________________________
