AO 100B (Rev. 01/09) Surety Property Owner or Third-Party Custodian Addendum UNITED STATES DISTRICT COURT for the __________ District of __________ United States of America v. ) ) ) ) ) Defendant Case No. SURETY PROPERTY OWNER OR THIRD-PARTY CUSTODIAN ADDENDUM (Under Fed. R. Crim. P. 49.1, this form may only be filed in court if redacted or under seal.) Use separate addendum for each surety, property owner, or third-party custodian. Attach photocopies of two pieces of personal identification, including at least one picture i.d. for each. Surety information: Name: Date of birth: Social Security No.: Immigration status: Alien Registration No.: Home address: Home/cell phone No(s).: Employer’s name: Employer’s address: Monthly salary (gross): $ Work phone No.: ’ months Length of employment: ’ years Source of additional income (if applicable): Amount of additional income (if applicable): Real property owned by surety (if more than one piece of property, please use additional sheets): Address: Value: $ Are payments/taxes current? ’ Yes ’ No Equity in property: $ Any holders of trust deeds: Is proof of surety’s title to property attached? AUSA: (initials) ’ Yes ’ No Appraisal? Surety: (initials) American LegalNet, Inc. www.FormsWorkflow.com AO 100B (Rev. 01/09) Surety Property Owner or Third-Party Custodian Addendum (Page 2) Affidavit by Owner of Cash Security (Complete if applicable) I, , declare that the $ cash deposited as security on the foregoing bond is owned by me and is to be returned to me at the address listed on page one of this addendum upon exoneration of this bond. I subject these funds to the provisions of any applicable local court rule and agree that in case of default or willful contempt of court on the part of the principal, the court may, upon at least 10 days notice to me, summarily render judgment against the cash security. Justification of Surety and Surety Agreement I, , declare under penalty of perjury, that my net worth is $ and that I have read and understand this two-page surety addendum. I further understand that by signing the appearance bond and this surety addendum, I will be responsible for the defendant’s appearances in court and the defendant’s compliance with all conditions of release as ordered by the court. If the defendant does not appear or comply with the conditions of release, I will be required to pay the amount of the bond, any security I have posted may be taken by the Government, and a judgment may be entered against me. If judgment is entered against me, a judgment lien will be filed with the county recorder in all appropriate counties for the full amount of the bond. I declare under penalty of perjury that all information contained in this bond and on this surety addendum is true. Date: Surety’s signature Signed before me. Signature of witness to surety’s signature Printed name of witness to surety’s signature Address of witness to surety’s signature AUSA: (initials) Defendant’s Attorney: (initials) American LegalNet, Inc. www.FormsWorkflow.com