CASE NAME: United States v_________________________ CASE NO.______________ SURETY ADDENDUM TO APPEARANCE BOND ( 2 pages) (Use separate addendum for each surety) ATTACH PHOTOCOPIES OF TWO PIECES OF IDENTIFICATION, INCLUDING AT LEAST ONE PICTURE I.D. FOR EACH SURETY Surety's Name: _________________________________________________________________ Date of Birth: ___________________________ S.S.#___________________________________ Immigration Status: __________________________________ "A" Number"__________________ Home address: __________________________________________________________________ _____________________________________________ Home Phone: ( )________________ Surety's relationship to defendant:_____________________________________________________ EMPLOYMENT AND SALARY INFORMATION: Employer's name: ________________________________________________________________ Employer's address: ______________________________________________________________ Length of employment: ______________________ Work phone: ( )______________________ Monthly salary (gross): $ ___________________________________________________________ ADDITIONAL INCOME INFORMATION: (complete if applicable) Source of additional income:_________________________________________________________ Amount of additional income: $ ________________________________________________________ REAL PROPERTY OWNED: (if more than one piece of property is owned please use additional sheet) Address: ______________________________________________________________________ Value of Property: $ _____________________________ Equity in property: $ _________________ Holder(s) of trust deed(s): __________________________________________________________ Are payments/taxes current? ________________________________________________________ Is proof of surety's title to property attached?_____________________Appraisal?______________ AUSA__________(initials) SURETY________(initials) Page 1 of 2 Surety Addendum American LegalNet, Inc. www.USCourtForms.com 2005 AFFIDAVIT BY OWNER OF CASH SECURITY (complete if applicable) I, ______________________________________________, on oath say that the $ ______________ cash deposited as security on the foregoing bond is owned by me and is to be returned to me at the address listed on page one of this surety addendum upon exoneration of this bond. I hereby subject said funds to the provisions of Local Court Rule 67.1 and consent and agree that in case of default or contumacy on the part of the principal, the Court may, upon notice to me of not less than ten days, proceed summarily and render judgment against said cash security in accordance with my obligation herein and award execution thereon. JUSTIFICATION OF SURETY AND SURETY AGREEMENT I, _______________________________, the undersigned surety, declare under penalty of perjury, that my net worth is the sum of $ ______________________ and that I have read and understand this two page Surety Addendum in its entirety. I further understand that by signing the appearance bond and this surety addendum to the appearance bond, I will be responsible for the defendant's appearances in court and the defendant's compliance with all conditions of release as ordered by the court. If the defendant does not appear or comply with the conditions of release, I will be required to pay the amount of the bond, any security I have posted may be taken by the Government to satisfy the bond, and a judgment may be entered against me. If judgment is entered against me a Judgment Lien will be filed with the County Recorder in all appropriate counties for the full amount of the bond. I declare under the penalty of perjury that all information contained in this bond and on this Surety Addendum is true, accurate, and complete. (Penalty for false statements: $250,000 fine and/or five years imprisonment, 18 U.S.C. § 1001.) Signature of surety: ____________________________________________ Date: ____________ Printed name and address of witness to surety's signature: _______________________________ ______________________________________________________________________________ Signature of witness: ___________________________________________ Date: ____________ AUSA_____(initials) DEFENSE ATTORNEY_______(initials) Page 2 of 2 Surety Addendum 2005 American LegalNet, Inc. www.USCourtForms.com