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I/We certify that the above information is true and correct. I/We also understand and acknowledge that by signing below, I/We am/are agreeing to indemnify and hold the Insurance Company and/or Mr. Bail Inc. and/or it’s Agent harmless from any and all cost and expenses that may be incurred by the Insurance Company and/or Mr. Bail Inc. and/or it’s Agent in the event that the said defendant fails to appear for any and all court dates. Also, I/We further understand that this is an application for a type of credit and authorize a review of my credit history (via) credit reporting agency checks.
WARNING: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO INJURE, DEFRAUD, OR DECEIVE ANY INSURER, FILES A STATEMENT OF CLAIM OR AN APPLICATION CONTAINING ANY FALSE, INCOMPLETE OR MISLEADING INFORMATION MAY BE FOUND GUILTY OF A FELONY.