Page 1 of 2Appearance Bond DC 3:1 Rev.10/2016

Nebraska State Court Form

APPEARANCE BOND DC 3:1 Rev. 10/2016 Neb. Rev. Stat. § 29-901

(Justification of Sureties on Reverse)

STATE OF NEBRASKA Plaintiff

vs.CASE No. ____________________

APPEARANCE BOND Defendant

I acknowledge that I’ve been charged with the offense(s) of

and in consideration of my release from custody agree to appear in the district court of said county on_________________, at________ ____.M. and thereafter as directed by the court, to answer the charges against me. I agree to abide by all of the conditions set forth below:

I understand that failure to appear as required by the court may cause a warrant for my arrest to be issued, and that further penalties may be imposed upon me, including forfeiture of this bond or bail, for willful failure to appear or for violation of any condition of this agreement upon which I am released. To guarantee my appearance, I do hereby acknowledge myself to be indebted to the State of Nebraska in the sum of $ which sum is hereby secured as follows:

PERSONAL RECOGNIZANCE in the sum of $_____________ . CASH: In lieu of surety or sureties, the defendant deposits cash bond to secure his appearance and conditions made therein in the sum of $_____________.10% BOND: Bond set in the amount of $__________, 10% of said amount or $____________ (not less than $25) deposited herewith in cash, 90% of which shall be returned to the defendant upon appearance as required above and 10% of which shall be retained by the clerk for bond costs.CORPORATE SURETY: In the sum of $_______________. Attached hereto.SURETY: The undersigned (surety) (sureties) do hereby acknowledge themselves to be bound as (surety)(sureties) of the defendant on the above appearance bond in the sum of $ with all conditions thereto.

Date Signature

Name (Defendant) Current Street Address/P.O. Box

Date of Birth City/State/ZIP Code

Phone Email Address

SURETY SIGNATURE: DATE: WITNESS SIGNATURE: DATE:

APPROVED BY THE COURT: Date: __________________ (Seal) (Clerk)

Not to leave the State of Nebraska without written permission from the court.Shall reside at the address as shown herein and hereby waives extradition from any other state or country to the State of Nebraska.Shall have no contact, directly or indirectly, with any co-defendant, witness, or alleged victim in this case or persons on probation or parole.Shall not be involved, directly or indirectly, in unlawful or disorderly conduct or acts injurious to others.

Agrees that if the court is informed that the conditions set forth herein have been violated, this bond may be revoked and a bench warrant issued without notice or hearing pending further review by the court.

Agrees to the following additional conditions:

Justification of Sureties (Sec. 25-2223 R.R.S., 1943)

Plaintiff

vs. Case No.

Defendant

and surety, or sureties on this appeal recognizance after being first duly sworn, deposes and says that I am a resident of the State of Nebraska and have real estate property situated in this county and state, TO WIT: (Legal Description)

Commonly known as (address) worth at least double the amount of this bond, beyond the amount of all liens and encumbrances thereon in addition to any exemptions allowed by law.

DATE: SURETY:

DATE: SURETY:

Subscribed in my presence and sworn to before me this date.

DATE: BY THE COURT: (Seal)

ASSIGNMENT

I hereby assign the proceeds of this bond to:

DATE: BY:

ADDRESS:

Page 2 of 2Appearance Bond DC 3:1 Rev.10/2016