JUSTICE COURT, HENDERSON TOWNSHIP CLARK COUNTY, NEVADA APPLICATION FOR RELEASE WITHOUT BOND/BAIL REDUCTION FORM HOME PHONE#: NAME: HOME ADDRESS: RENT OWN HOW LONG THERE?: MONTHLY PAYMENT/RENT: HOW LONG IN CLARK COUNTY? DATE OF BIRTH: SOCIAL SECURITY #: DRIVER'S LICENSE NUMBER / STATE? ARE YOU PRESENTLY EMPLOYED?: OCCUPATION: EMPLOYER: EMPLOYER'S ADDRESS & PHONE NUMBER: HOW LONG? OTHER SOURCES OF INCOME EARNINGS: NAME OF SPOUSE OR SIGNIFICANT OTHER: MARITAL STATUS? NUMBER OF DEPENDENTS: LIST ALL AGES & RELATIONSHIPS: NAME / ADDRESS OF PARENTS OR RELATIVES (LIST LOCAL, THEN OUT OF STATE) 1. 2. 3. 4. SAVINGS ACCOUNT CHECKING ACCOUNT BALANCE BALANCE LIST ALL REAL AND PERSONAL PROPERTY AND ITS VALUE (Land, Jewelry, Furs, Stocks, Bonds, Etc.) LIST MOTOR VEHICLES, BOATS, CAMPERS OWNED: YEAR/MAKE PRESENT VALUE: BALANCE DUE: YEAR/MAKE PRESENT VALUE: BALANCE DUE: YEAR/MAKE PRESENT VALUE: BALANCE DUE: HAVE YOU EVER BEEN ARRESTED? MISDEMEANOR? FELONY? CHARGES: YEAR: SENTENCE: HAVE YOU EVER FAILED TO APPEAR IN COURT? - FOR OFFICIAL USE ONLY O.R. Granted O. R. Denied Bail Re-Set Signature SIGNATURE DATE PRINT NAME OF PERSON COMPLETING APPLICATION RELATIONSHIP TO DEFENDANT: SELF SPOUSE RELATIVE ATTORNEY American LegalNet, Inc. www.FormsWorkflow.com