AOC-480 Rev. 4-01 Page 1 of 1 Doc. Code: BP Case No. Court ENTRY OF APPEARANCE & PLEA OF GUILTY (PERFORMANCE BOND) County Commonwealth of Kentucky Court of Justice 1) 2) I, ____________________________________________________________ hereby waive service of process Citation Number ________________, charges me with the following offense(s): [Give statute number(s) or describe offense(s) charged] and voluntarily enter my appearance in the action. ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ 3) 4) I plead guilty to the above-charged offense(s). As further evidence of my intent to plead guilty, I am posting a performance bond in the amount of $________________ to cover the possible fine and court costs in the action which may be assessed against me by the trial court. I realize that when judgment is entered in the action, the money deposited for the bond will be applied toward my fine and costs, and the balance, if any, will be returned by mail to me at: Address: ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ______________________________________ Defendant's Signature ________________________________________________________________ TO BE COMPLETED BY COURT CLERK AND MAILED TO DEFENDANT: TO THE ABOVE-NAMED DEFENDANT, ______________________________________________________________: This is to inform you judgment has been entered against you by the District Court of ___________________ County on the _____ day of _______________, 2_____, in the amount of $_________________ (fine and costs) for violation of KRS __________________________________________________________________________________. This judgment was satisfied by application of the money you deposited as a performance bond. After application of the bond to the fine and costs, $__________________ remained. This amount is being returned to you. __________________________________ Clerk By: _______________________________ D.C. Distribution: Court File Defendant Date: ______________________, 2_____. Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com