IN THE SUPERIOR COURT OF THE STATE OF DELAWARE COUNTY:  New Castle STATE OF DELAWARE, ) ) ) ) ) v. [DEFENDANT(S])  Kent  Sussex Cr. No. AFFIDAVIT BY INDIVIDUAL OWNER POSTING CASH SECURITY Cash Bond This is a cash bond of $________________________, secured by $____________________, in cash deposited with the Court. Forfeiture or Release of the Cash Bond Forfeiture of the Cash Bond. This bond may be forfeited if the defendant does not comply with a court’s order. The court may immediately order the amount of the bond surrendered to the State of Delaware, including the security for the bond, if the defendant does not comply with the conditions of the bond. The Court may order a judgment of forfeiture against the defendant and each surety for the entire amount of the bond, including interest and costs. Release of the Bond. The Court may order this bond ended at any time. This bond will be satisfied and the security will be released when either: (1) the defendant is found not guilty on all charges, (2) the defendant reports to serve a sentence, or (3) the Court has modified the bail. Declarations Ownership of the Cash Security. I, ________________________________, declare that the $_______________________, cash deposited as security on the above referenced bond is owned by me and is to be returned to me at the address listed below. By declaring that I own the cash deposited as security, I confirm that the cash has not been provided to me by another person, association or entity. I, further, declare that I have not been paid or promised anything of value or any favorable treatment in return for posting this cash security. Acceptance. I, __________________________ have read this affidavit of posting cash bond and if I had any questions regarding this affidavit and its meaning I have raised those questions and they have been answered. I, __________________________________, declare under penalty of perjury that the information above is true. Date: __________________ ____________________________________ Cash Security Owner __________________________________ Cash Security Owner – print name ____________________________________ Cash Security Owner – print address ____________________________________ ____________________________________ PROTHONOTARY Date: __________________ ____________________________________ Signature of Prothonotary, Deputy, or Designee American LegalNet, Inc. www.FormsWorkFlow.com