Original - Court 1st copy - Defendant 2nd copy - Extra Approved, SCAO STATE OF MICHIGAN JUDICIAL DISTRICT JUDICIAL CIRCUIT ORI CASE NO. BOND INTERIM AMENDED Court address Court telephone no. MIDefendant's/Juvenile's name, address, and telephone no. The State of Michigan THE PEOPLE OF v Date of birth Date of arrest Type of offense Misdemeanor CTN/TCN Arresting agency Agency file no. Felony Offense(s) Statute/ordinance citation(s) Purpose of next appearance Time of appearance Date of appearance Place of appearance Bond denied At the court address above Other: Personal recognizance Full bail amount TYPE OF BOND: Cash/Surety Bond set by Judge/Magistrate Real property* $ Cash/Surety/10% Cash *Proof of value and interest in real property is required TERMS AND CONDITIONS See terms and conditions on other side of this form I have read and agree to the terms and conditions as specified on the other side of this bond and as follows: I will abide by the other conditions specified in items: List, by number, all items ordered in the Pretrial Release. Include any specific details. which are listed on the back of this bond. I understand if I fail to perform all the terms and conditions of this bond, my release may be revoked and I will be subject to arrest, and the full amount of the bond may be forfeited and judgment entered for the entire amount of the bond. Date Defendant's signature Bond Deposited by Defendant: If all the terms and conditions of this bond are met, it will be used to pay any fine, state minimum costs, restitution, statutory assessments, and other costs imposed and any balance will be returned to me as authorized by statute and court rule. Date Defendant's signature Bond Deposited by Third Party: Surety/Agent: I understand and agree if all the terms and conditions on the face and on the back of this bond are not met by the defendant, the full amount of the bond may be forfeited and a judgment entered for the entire amount of the bond. If all the terms and conditions of this bond are met, the full amount of the bond will be returned to me unless I deposited a 10% cash bond. In that instance, the court will return only 90% of it to me. Date Signature of depositor/surety/agent and identification (i.e. DLN) Name of depositor/surety/agent Address City, state, zip ACCEPTANCE Date MC 241 (1/08) Bond is accepted. BOND Received deposit of $ . Signature MCL 765.6c, MCL 765.6d, MCL 780.582a, MCR 6.102(D), (F), MCR 6.106, MCR 6.610, 18 USC 922(g)(8) American LegalNet, Inc. www.FormsWorkflow.com TERMS AND CONDITIONS By signing this bond I agree to the following terms and conditions and any other conditions specified on the face of this bond. 1. I will personally appear for any examination, arraignment, trial, or sentencing and will appear at such other times and places as may be directed by the district court or by the circuit court. If I am represented by an attorney in this case, any notice to appear may be given to my attorney in place of personal notice to me. 2. I will abide by any judgment entered in this case and will surrender myself to serve any sentence imposed. 3. I will not leave the State of Michigan without the permission of the court having jurisdiction over my case. 4. I will not commit any crime while released. 5. I will immediately notify in writing the court having jurisdiction over my case of any change in my address or telephone number. 6. I will abide by any other conditions described on the face of this form and in any release order. 7. I understand that if I violate items 12 or 13 (if conditions of my release), I am subject to arrest without a warrant and may have my bond forfeited or revoked and new conditions of release imposed, in addition to any other penalties that may be imposed if I am found in contempt of court. 8. I understand that if I violate any of the terms and conditions of this bond and am arrested for the violation in another state, that I waive all extradition proceedings and will be immediately returned to this state. Other Conditions: TO: Person preparing the Bond or the sheriff/jailer/law enforcement agency holding the defendant/juvenile. If the court ordered any of the following additional conditions of release on the Pretrial Release Order, they must be specified on the face of this bond. Please indicate each applicable condition by the corresponding item number. TO: Defendant/Juvenile. If any of these items are specified on the face of this bond, by signing this bond, you are agreeing to abide by them. The conditions applicable to you will be identified on the face of the bond by item numbers. Item 1. Make reports to a court agency as are specified by the court or the agency. Item 2. Not use alcohol nor illicitly use any controlled substance. Item 3. Participate in a substance abuse testing or monitoring program. Item 4. Participate in a specified treatment program for any physical or mental condition, including substance abuse. Item 5. Comply with restrictions on personal association, place of residence, place of employment, or travel. Item 6. Surrender driver's license or passport. Item 7. Comply with a specified curfew. Item 8. Continue to seek employment. Item 9. Continue or begin an educational program. Item 10. Remain in the custody of a responsible member of the community who agrees to monitor the defendant/juvenile and report any violation of any release condition to the court. Item 11. Not possess or purchase a firearm or other dangerous weapon. Item 12. Not harass, intimidate, beat, molest, wound, stalk, threaten, or engage in other conduct that would place any of the following persons or a child of any of the following persons in reasonable fear of bodily injury: spouse, former spouse, individual with whom defendant has a child in common, resident or former resident of defendant's household. This item is used for NCIC entry Item 13. Not assault, harass, intimidate, beat, molest, wound, or threaten a named person or persons (add name(s) on the face of the bond). Item 14. Satisfy any injunctive order made a condition of release. Item 15. Not have (or cause any third party to have) any direct or indirect contact with (add name(s) to face of bond) and not enter specified premises or areas (add address(es) to face of bond). Item 16. May go to the residence one time accompanied by peace officer to remove personal belongings. Item 17. Comply with any other condition, including the requirement of money bail. Item 18. Other. NOTICE OF FIREARMS RESTRICTION: If item 12 is listed as a condition of your release, federal and/or state law may prohibit you from possessing or purchasing ammunition or a firearm (including a rifle, pistol, or revolver). American LegalNet, Inc. www.FormsWorkflow.com