Indemnitor Application

Indeminitor Full Name:

Relation to Defendant:

County you live:

Cell Phone:

Date of Birth:

Height:

State:

Social Security:

Sex":

Defendant Name:

Home Phone:

Current Address

Landlord Phone Number:

Do you rent or own

Driver's Lic #

Place of Birth:

Race:

Weight:

Employment:

Occupation:

Employer:

Employer Address:

Length of Employment:

Name of you Supervisor:

Phone Number:

Marital Status:

Matital Status:

Address:

Occupation:

Spouse Name:

Cell Phone:

Vehicle Information:

Year:

Make:

Color:

Plate:

Where financed:

Amount Owed:

Insurance Company:

Model:

Personal References:

*Please provide 3 personal references, excluding the defendant and the reference's defendant may use on his/her application.

Reference Name:

Relationship:

Phone Number:

Address:

Years Known:

Reference Name:

Relationship:

Phone Number:

Address:

Years Known:

Reference Name:

Relationship:

Phone Number:

Address:

Years Known:

Notice of Privacy Policy

Notice of Privacy Policy
Sun surety company (SSC) is committed to protecting the privacy of personal information of our clients. This policy will ensure the continued protection of nonpublic personal information and inform you about the measures SSC takes to safeguard that information.

Who is covered?

We provide our Privacy Policy to each customer when they purchase a bail bond through SSC Generally, this means that the Privacy Policy is provided to the customer at the time a bail bond is issued.

Access to Information

Access to all private personal information is limited to those employees who need to know how to perform their work. These employees include, but are not limited to, those in departments such as legal, underwriting, claims, administration, and accounting.

Information Sharing

Generally, SSC does not share nonpublic personal information that it collects with anyone other than its policy issuing agency as needed to issue the bail bond as requested by the customer. SSC, however, may share information as required by law in response to a subpoena, to a government regulatory agency or to prevent fraud.

Information Security

SSC always strives to maintain the confidentiality and integrity of the personal information in its possession and has instituted measures to guard against its authorized access. We maintain physical, electronic and procedural safeguards in compliance with federal standards to protect that information.

Under penalty of perjury, I swear that I have read the foregoing and that the declarations made, and answers given by me are the truth without reservation. Said declarations and answers are made for the purpose of including the Surety to undertake the bond(s) applied for herein, and with the intent and purpose that they be fully relied upon. By signing below, I further agree to indemnify and hold harmless the Surety Company and the Agents for any and all losses not otherwise prohibited by law, or rule and regulation promulgated under any applicable statue that may result from the execution on the bond(s) applied for herein.

I have read and agree to the Terms and Conditions and Privacy Policy

WARNING: ANY PERSON WHO, KNOWINGLY AND INTENT TO INJURE, DEFRAUD OR DECEIVE ANY INSURER, FILES A STATEMENT OF CLAIM OR AN APPLICATION CONTAINING ANY FLASE INCOMPLETE OR MISLEADING INFORMATION IS GUILTY OF A FELONY OF THE THIRD DEGREE.

Signature:

Date:

Take a photo of the license on both sides

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