APPLICATION FOR BOND IN THE JUVENILE COURT OF __________________________ COUNTY, GEORGIA In the Interest of: CASE NUMBER_____________________ ______________________________, SEX _______________________________ Child. DOB ________________ AGE _________ Now comes ___________________________________________________________________, (Name) parent/guardian/legal custodian of _________________________________________________, (Juvenile) being held in the _________________________________________ charged with the offense(s) of____________________________________________________________________________ and respectfully requests that the within named child be released on bond returnable to this juvenile court in the custody of the undersigned, to be returned to this Court at a date and time to be specified. This ____________ day of _______________________________ 20____. _____________________________ (Name) _____________________________ (Street) _____________________________ (City, State, Zip Code) Witness: ____________________________ Application denied/approved and bond set in the amount of $______________ This ____________ day of _______________________________ 20____. ___________________________________ Judge/Associate Judge of ___________________ County Juvenile Court Rev. 01/2001 JUV-11