AO 100A (Rev. 01/09) Bail Information Sheet
UNITED STATES DISTRICT COURT
for the __________ District of __________ United States of America v. ) ) ) ) )
Case No.
Defendant
BAIL INFORMATION SHEET (Under Fed. R. Crim. P. 49.1, this form may only be filed in court if redacted or under seal.) Defendant's information: Name: Date of birth: Immigration status: Home address: Home/cell phone No(s).: Employer's name: Employer's address: Work phone No.: Length of employment: ' months ' years Social Security No.: Alien Registration No.:
Name, address, and phone number of any persons with whom defendant will live during pendency of the case:
Name, address, and phone number of any persons residing in the United States who will know how to contact defendant, aside from sureties on this bond:
I swear under penalty of perjury that the above information is true.
Defendant's signature
Defendant's attorney information: Name: Address: Phone(s):
AUSA:
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Defendant's Attorney:
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