CASH BOND ASSIGNMENT To request a cash bond assignment, complete this form, including notarization and mail to: Harris County District Clerk’s Office P.O. Box 4651 Houston, TX 77210-4651 Without notarization the form must be filed in person by the depositor at 1201 Franklin, Suite 3180. Depositor must provide proper identification. It is essential that cash bond assignments are completed and filed prior to the conclusion of the criminal case. ***************************************************************************** NO. THE STATE OF TEXAS § VS. § COUNTY CRIMINAL COURT @ LAW NO. § DISTRICT COURT HARRIS COUNTY, TEXAS I, , Cash Bond Depositor, in the above numbered and styled cause, do hereby assign, transfer and to be made payable to (Name) my cash refund in the amount of $ and styled cause. (Address) upon final disposition of the above numbered Depositor Signature STATE OF TEXAS § COUNTY OF HARRIS § Before me the undersigned authority personally appeared, , who being represented to me as the person whose name is subscribed to the foregoing instrument, American LegalNet, Inc. www.FormsWorkFlow.com acknowledged to me that he executed the same for the purposes of consideration therein expressed. Given under my hand and seal of office this day of , A.D. . Notary signature, seal, and expiration CHRIS DANIEL, District Clerk Received By: _________________________ American LegalNet, Inc. www.FormsWorkFlow.com