Nj Bail Source Form – Fill Out and Use This PDF

Bail Source Inquiry Questionnaire

Pursuant to N .J .S .A . 2A:162 -13, a person charged with a crim e with bail restrictions m ust provide, under penalty of perjury, inform ation “about the obligor, indem nifier or person posting cash bail, the security offered, and the source of any m oney or property used to post the cash bail or secure the surety or bail bond, as the case m ay be. This required inform ation shall include, but not be lim ited to, the defendant’s em ployment history, the names and addresses of any persons who contributed m oney or pledged security for the proffered bail or toward a surety bond, the am ount, nature and tim ing of such contributions, and the relationship to the defendant of any such persons contributing resources. Bail m ay not be accepted from a person subject to the requirem ents of this subsection until the prosecutor is provided the com pleted form required by this subsection .

Attorney General form P.L. 2007, c. 46	Defendant’s Name:
	Complaint/Warrant Numbers:

I. INFORMATION ON DEFENDANT

NAME OF DEFENDANT FOR W HOM BAIL OR BOND IS POSTED:

Defendant’s Date of Birth:

Defendant’s Social Security Number:

Bail Amount:

ADDRESS WHERE DEFENDANT WILL LIVE WHILE ON BAIL:

	DEFENDANT’S EMPLOYMENT HISTORY (Last 3 years):
	Name of Employer	Address	Title	Dates of	Monthly Income
				Employment

1.

2.

3.

4.

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Attorney General form P.L. 2007, c. 46	Defendant’s Name:
	Complaint/Warrant Numbers:

II. INFORMATION ON INDIVIDUALS POSTING BAIL

Instruction: Defendant must provide information on all individuals contributing to anything of value to be used to post cash bail or secure the surety or bail bond (including defendant) and all individuals contributing to posting money to secure a bond. Fill in a separate box for each individual.

LIST NAME, ADDRESS, CONTACT INFORMATION, RELATIONSHIP, AND AMOUNT OF MONEY OR PROPERTY POSTED:

				Relationship to	Amount of Money
	Name	Address	Telephone		posted for bail or to
				Defendant
					secure bond

INDICATE FROM WHAT SOURCE THE PERSON LISTED ABOVE OBTAINED THE MONEY OR PROPERTY POSTED FOR BAIL OR FOR SECURING A BOND:

Name of Bank

City and State

Savings Account

Checking Account

Credit Card Advancement

Investment Account

Other

	Cash (for posting bail or securing bond)	MUST COMPLETE SECTION IV. (Page 6)

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Attorney General form P.L. 2007, c. 46	Defendant’s Name:
	Complaint/Warrant Numbers:

LIST NAME, ADDRESS, CONTACT INFORMATION, RELATIONSHIP, AND AMOUNT OF MONEY OR PROPERTY POSTED:

				Relationship to	Amount of Money
	Name	Address	Telephone		posted for bail or to
				Defendant
					secure bond

INDICATE FROM WHAT SOURCE EACH PERSON LISTED ABOVE OBTAINED THE MONEY OR PROPERTY POSTED FOR BAIL OR FOR SECURING A BOND:

Name of Bank

City and State

Savings Account

Checking Account

Credit Card Advancement

Investment Account

Other

Cash (for pending bond or securing bond) MUST COMPLETE SECTION IV. (Page 6)

3

Attorney General form P.L. 2007, c. 46	Defendant’s Name:
	Complaint/Warrant Numbers:

LIST NAME, ADDRESS, CONTACT INFORMATION, RELATIONSHIP, AND AMOUNT OF MONEY OR PROPERTY POSTED:

				Relationship to	Amount of Money
	Name	Address	Telephone		posted for bail or to
				Defendant
					secure bond

INDICATE FROM WHAT SOURCE EACH PERSON LISTED ABOVE OBTAINED THE MONEY OR PROPERTY POSTED FOR BAIL OR FOR SECURING A BOND:

Name of Bank

City and State

Savings Account

Checking Account

Credit Card Advancement

Investment Account

Other

Cash (for pending bond or securing bond) MUST COMPLETE SECTION IV. (Page 6)

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Attorney General form P.L. 2007, c. 46	Defendant’s Name:
	Complaint/Warrant Numbers:

III. INFORMATION OF BAIL BOND COMPANY

Instruction: Attach any and all documents related to the securing of bail including, but not limited to, Bail Agreements, Receipts, Copies of checks, Promissory Notes, Employment and Income Verification documents, Property Checks and Appraisals.

NAME OF BAIL BOND COMPANY POSTING BOND:

Address / Phone:

Contact Person:

License / Registration Number:

I certify that the information contained in this document is true and accurate to the best of my knowledge under penalty of perjury.

Defendant’s Signature

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Attorney General form P.L. 2007, c. 46	Defendant’s Name:
	Complaint/Warrant Numbers:

IV. SOURCE OF CASH BAIL FORM

Instruction: Defendant must provide information on all individuals contributing to posting cash bail (including defendant) and all individuals contributing to posting cash to secure a bond. As to each individual, provide the following:

1. Employer information and annual salary including wages or income as an independent contractor or cash worker for the last 3 years:

2. All monetary gifts received for the last 3 years including amount and source:

3. List all forms of public assistance (city, county, State, Federal) you have applied for or received either for yourself or for any dependent member of your household:

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Attorney General form P.L. 2007, c. 46	Defendant’s Name:
	Complaint/Warrant Numbers:

4. List all sources of rental income you have received for the last 3 years including the address of the leasehold:

5. All jurisdictions (city, State, Federal) to which you filed income tax returns for the last 3 years:

6. List all forms of real property in which you hold an interest as a deed holder, mortgagor or mortgagee, lessor or lessee:

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Attorney General form P.L. 2007, c. 46	Defendant’s Name:
	Complaint/Warrant Numbers:

7. List all judgments/liens filed against you or any real property in which you have an interest as identified in 6, above:

8. List all creditors to whom/which you have made application for the extension of credit in the past 3 years:

I certify that the information contained in this document is true and accurate to the best of my knowledge under penalty of perjury.

Defendant’s Signature

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