CLERK OF THE COURT SUPERIOR COURT OF ARIZONA MARICOPA COUNTY 201 WEST JEFFERSON PHOENIX, AZ 85003 Michael K Jeanes Clerk (602)37-CLERK, or (602)372-5375 Fax# 602-506-7684 BOND FORFEITURE WIRE FORM The Accounting Division within the Clerk's Office is responsible for entering and holding all bond funds in an automated trust accounting system until the Court issues an order releasing the funds. The Trust system serves as the official record for the Superior Court; it is of the utmost importance that the bond and payer information be complete and accurate. Return completed forms to: TrustResponse@mail.maricopa.gov. Bank Account Information Bank Name: Bank Address: Account #: Routing #: Detail Information Swift Code: JP Morgan Chase 201 North Central Avenue Phoenix, AZ 85004 982585499 Central Depository Account ABA: 021000021 -or- ACH: 122100024 Superior Court case number Name of party funds are being paid on behalf of CHASUS33 Payer Information Payer Name: Payer Address: Telephone #: e-Mail Address: Total Wire Amount: $ Deposit Information Superior Court Case Number Defendant Name Forfeited Amount Bond Forfeiture Forfeiture Interest Total Amount: $ L.R.D. 04-30-14 American LegalNet, Inc. www.FormsWorkFlow.com