___________________County, Colorado ! County Court ! District Court _____________________________________Municipal Court, Colorado Court address: Phone Number : VS. COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: FAX Number: BOND POSTED FOR: E-mail: Atty. Reg #.: NOTICE OF BAIL FORFEITURE ! Defendant ! Respondent Case Number: Arrest Number: Warrant Number: Bond Number: Division Courtroom ! Petitioner ! Plaintiff ! Child NAME OF PARTY (print or type): ________________________________________________________________________________ First Middle Last DOB RE: POWER OF ATTORNEY # ________________________ TO: ___________________________________________________, Bail Bonding Agent ___________________________________________________, Bail Insurance Company YOU ARE NOTIFIED THAT on _______________________________ (forfeiture date), because of the party’s failure to appear in accordance with the primary condition of the bond, the court ordered that the bond posted on ________________________ (date), in the amount of $___________________________ be forfeited pursuant to C.R.S. 16-4-112, and that this notice issue. YOU HAVE THE RIGHT to request a show cause hearing pursuant to C.R.S. 16-4-112(5)(b)(III), within fifteen days after receipt of this notice to show cause why judgment on the forfeiture should not be entered for the State of Colorado. IN THE ABSENCE of a request for a show cause hearing, the Court will enter judgment for the State of Colorado against the compensated surety or sureties thirty days after the forfeiture date. Any request for a show cause hearing must be made within fifteen days of receipt of this notice. NOTICE IS GIVEN that the period for satisfaction of the judgment by the bail bonding agent pursuant to C.R.S. 16-4-112(5)(b)(IV), will expire on ____________________________, (120 calendar days from the forfeiture date shown above.) If the bond is not exonerated, or the judgment not satisfied by that date, this court will place the bail bonding agent on the “Board”, and the agent will not be permitted to post any further bonds in the State of Colorado pursuant to C.R.S. 16-4-112(5)(e). CLERK OF COURT DATE: ______________________________________ ___________________________________________ Deputy Clerk CERTIFICATE OF SERVICE I certify that on ___________________________ (date), I served a copy of the Notice of Bail Forfeiture by personal service or certified mail to the Bail Bonding Agent listed below and regular, postage, prepaid, to the Bail Insurance Company listed below: ______________________________________________ ___________________________________________ Bail Bonding Agent Bail Insurance Company Address: ________________________________________ City & State: ______________________________________ Prosecuting Attorney: Address: _____________________________________ City & State: ___________________________________ Clerk of Court: ___________________________________________ Deputy Clerk JDF 374 R1/00 NOTICE OF BAIL FORFEITURE 2001 © American LegalNet, Inc.