NOTES ON USE: DO NOT SEND THIS FORM, UNLESS THE COURT PREVIOUSLY SENT AN ORDER TO THE DIVISION OF INSURANCE ! Municipal Court ! County Court ! District Court ___________________________________________County, Colorado Court Address: VS. COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Case Number: Arrest Number: Warrant Number: Bond Number: Phone Number: E-mail: FAX Number: Atty. Reg. #: Division Courtroom NOTICE TO DIVISION OF INSURANCE OF EXONERATION OF COMPENSATED SURETY BOND POSTED FOR: ! Defendant ! Respondent ! Plaintiff ! Petitioner ! Child NAME OF PARTY (print or type): ________________________________________________________________________________ First Middle Last DOB RE: POWER OF ATTORNEY # ________________________ THE COURT FINDS that: 1. On (date) __________________________, the court ordered the Division of Insurance to commence proceedings pursuant to C.R.S. 12-7-103(3), with respect to a bail bond posted on (date) _______________________________, in the amount of $ ___________________________. The bond was executed and posted in this action by a licensed Colorado bail bonding agent, as agent for a bail insurance company *. 2. On (date) __________________________, said compensated surety or sureties were removed from the board by reason of the following: ! The bond judgment which was the subject of the Order was vacated and/or set aside by this court; or ! The judgment was satisfied and the Clerk of this Court has issued a full satisfaction of the judgment against the bail bonding agent and surety company *. THIS COURT’S prior order to the Division of Insurance to commence proceedings pursuant to C.R.S. 12-7-103(3) is hereby vacated and set aside. BY THE COURT: DATE: ________________________________________ *Strike if inapplicable ___________________________________________ Judge CERTIFICATE OF SERVICE I certify that on (date) _____________________________, I served a copy of the NOTICE TO DIVISION OF INSURANCE OF EXONERATION OF COMPENSATED SURETY by personal service or regular mail, postage prepaid, to the following: __________________________________________________ ________________________________________________ (Bail Bonding Agent) (Bail Insurance Company) Address: ____________________________________________ City & State: __________________________________________ Division of Insurance c/o Bail Bond Investigations Department of Regulatory Agencies 1560 Broadway, Suite 850, Denver, CO 80202 Address: __________________________________________ City & State: ________________________________________ CLERK OF THE COURT ___________________________________________ Deputy Clerk JDF 381 R1/00 NOTICE TO DIVISION OF INSURANCE OF EXONERATION OF COMPENSATED SURETY 1 2002 © American LegalNet, Inc.