Free mc92.p65 - Michigan

Approved, SCAO

Original - Court 1st copy - Respondent

3rd copy - Arresting agency 4th copy - Depositor

STATE OF MICHIGAN JUDICIAL CIRCUIT JUDICIAL DISTRICT COUNTY
Court address

CASE NO. CASH BOND
Court telephone no.

Plaintiff

v

Defendant

Date of arrest

Arresting agency and address

Agency file no.

RECEIPT Received from (referred to in this receipt as "the depositor") $

to assure appearance of (referred to in this receipt as "the respondent") for contempt of court. The respondent shall appear for hearing at a date noticed by the court. If the respondent fails to appear at the time and place indicated in the court's notice and submit to the jurisdiction of the court and fails to abide by an order of the court, the cash bond deposited shall be disposed according to the order of the court. If the warrant that resulted in this arrest arises from a case in which the respondent has an unpaid judgment, the cash bond may be transmitted to the creditor holding the judgment. By depositing the cash bond with the officer and accepting this receipt, the depositor waives a claim to the money under the cash bond following its disposition as ordered by the court.

Date Officer Department

Signature of depositor of money Department receipt number

TERMS AND CONDITIONS To secure my release from custody until the court hearing, I promise: 1. I will personally appear at the time and place as directed by the court. 2. I will immediately notify the court in writing of any change in my address or telephone number. I understand that at the hearing the court will determine how much of the bond money will be applied to any outstanding judgment in this case and how much, if any, will be returned to the depositor. I understand that if I fail to appear, the court will issue a bench warrant for my arrest and the bond money posted may be forfeited or applied to any outstanding judgment in this case.

Signature of respondent Address of respondent City, state, zip Date of birth Driver license no. MC 92 (6/05)

Date Employer Employer's address City, state, zip

CASH BOND

MCR 3.604, MCL 600.1701