UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MISSOURI (This Document to be completed in the presence of Court personnel only) UNITED STATES OF AMERICA, Plaintiff -vs, Defendant | | | | | | | | Case No. . AFFIDAVIT OF OWNERSHIP I, , on oath say that . is/are the legal owner(s) of the $ cash deposited as security on the bond posted for the defendant named above. The funds deposited are to be returned to the said owner(s) upon exoneration of this bond. I understand that this bond is subject to forfeiture if the defendant does not comply with conditions set by the Court. Date Signature of Owner/Agent of Owner of cash security Address City/State/Zip Subscribed and sworn to before me this __________ day of ________________, 20____. JAMES G. WOODWARD, CLERK By: _______________________________ 2002 © American LegalNet, Inc. Deputy Clerk