Fillable APPLICATION FOR EMPLOYEE CARD TOM GREEN COUNTY BAIL (Tom Green County)

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APPLICATION FOR EMPLOYEE CARD TOM GREEN COUNTY BAIL (Tom Green County)

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The APPLICATION FOR EMPLOYEE CARD TOM GREEN COUNTY BAIL (Tom Green County) form is 6 pages long and contains:

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1
APPLICATION FOR EMPLOYEE CARD
TOM GREEN COUNTY BAIL BOND BOARD
TOM GREEN COUNTY TREASURER’S OFFICE
SAN ANGELO, TX
****
*********************************************************************************
NO APPLICATION SHALL BE DEEMED COMPLETE NOR SHALL ANY LICENSE ISSUED BECOME EFFECTIVE
UNTIL ALL APPLICABLE PROVISIONS OF THE TEXAS OCCUPATIONS CODE, CHAPTER 1704, AND THE
CURRENT RULES AND REGULATIONS OF THIS BOARD HAVE BEEN FULLY COMPLIED WITH.
E
mployee Name _______________________________________________________________________
E
mployee Signature
______________________________________________________________________
FOR BOARD USE ONLY
DO NOT WRITE BELOW THIS LINE
Application Received by: ______________________________ Date: ___________________________
B
ail Bond Licensee: _____________________________________________________________________
A
ssumed Name of Licensee’s Company: ____________________________________________________
O
utstanding un-satisfied forfeitures of judgments in any County: ________________________________
C
onditionally Approved / Denied Date: ___________________________
A
pplication Final Approval Granted By Board and License Issued on: _____________________________
E
mployee Card Number: _____________ Date Expires: __________________________________
New Application _____
Renewal Application _____
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signature
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2
CHECKLIST OF DOCUMENTS REQUIRED FOR APPLICATION TO BE CONSIDERED BY THE BOARD
_____ A. Complete Original Application
_____ B. Two passport-sized photos of the applicant employee.
_____ C. One full set of applicant’s fingerprints. If this is a renewal application of a current
Employee Card, the fingerprint card currently on file with the Tom Green County
Sheriff’s Office is sufficient.
_____ D. A Certified Copy of the applicant’s Criminal History provided by the Texas Department
of Public Safety.
ORIGINAL or RENEWAL (Circle One) EMPLOYEE CARD APPLICATION
If Renewal, Current Employee Card Number: ________________________________________________
Expiration Date of Current Employee Card: _________________________________________________
Bail Bond Company Employee Since: _______________________________________________________
3
APPLICATION FOR TOM GREEN COUNTY BAIL BOND EMPLOYEE CARD
The undersigned licensee is currently in good standing with the Tom Green County Bail Bond
Board and requests that the Board authorize the below named person to act as an employee on behalf
of the licensee in Tom Green County. Licensee understands and agrees that if this application receives
approval, licensee shall be responsible for all bail bonds handled by the employee unless licensee
informs the Board, pursuant to the procedures established in T.T.C.A. OCCUPATIONS CODE CHAPER
1704, and the TOM GREEN COUNTY BAIL BOND BOARD RULES, as amended, of any termination of
employment.
1. Bail Bond Licensee: ______________________________________________________________
Assumed Name of Licensee’s bonding Company: ______________________________________
Business Address: _______________________________________________________________
City, State, Zip code: _____________________________________________________________
Business Telephone:___________________________ Fax: _____________________________
2. Prospective Employee’s Name: ________________ ______
Age: _________
DL State: ____ DL #: ________________________ Date of Birth: _____________________
Home Address: _________________________________________________________________
City, State, Zip code: _____________________________________________________________
Home Telephone: _____________________________ Fax: _____________________________
Length of Residence in Texas: ____ Citizen of the United States: Yes ___ No ___
3. Prospective Employee’s Spouse’s Name: ________________ Age: _________
DL State: ____ DL #: ________________________ Date of Birth: _____________________
Home Address: _________________________________________________________________
City, State, Zip code: _____________________________________________________________
Home Telephone: _____________________________ Fax: _____________________________
4. Prospective Employees’s Present Employer: __________________________________________
Type of Business: _______________________________ Telephone: _______________________
Address: _______________________________________________________________________
Starting Date: __________________________ Present Title: ____________________________
Present Duties: _________________________________________________________________
Supervisor’s Name and Phone: _____________________________________________________
May we contact your present employer? Yes ____ No ____
Does your employer know you are applying for a bail bond license? Yes ____ No ____
4
5. Has the prospective employee ever been connected in any way with any bail bonding company
other than the current licensee: (Including ownership, partial interest in, worked for, etc.)?
Yes ____ No ____. If “Yes”, give full details including name, address, and telephone number of
bonding company, name of licensed bondsman, county and license number, as well as dates of
employment, and reasons for leaving employment:____________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
6. Has the prospective employee ever been denied or refused a Bail Bond License or Bail Bond
Employee Card in any state or withdrawn an application to avoid such action? Yes____ No____.
If “Yes”, give full details including State, County, date and reason for denial or refusal: ________
______________________________________________________________________________
______________________________________________________________________________
7. Has the prospective employee ever been convicted of any felony or misdemeanor offense, in
any jurisdiction? Yes ____ No ____. If “Yes”, give full details including jurisdiction, State,
County, case number, Court, charge, date of offense, and final disposition: _________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
8. Are there any felony or misdemeanor charges currently pending against this prospective
employee? Yes ____ No ____. If “Yes”, give full details including jurisdiction, State, County,
case number, Court, charge, date of offense:_________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
9. Licensee and employee agree that the Board may conduct an investigation into the prospective
employee’s criminal history and may consider the same in issuing, denying, suspending or
revoking any approval of the employee’s authority to act as an employee. Furthermore,
licensee and employee understand and agree that if, after the issuance of an employee
identification card, and indictment is returned or an information and complaint are filed
charging employee with commission of offense or an offense involving moral turpitude, the
licensee shall immediately notify the Board, suspend the authority of the employee and return
5
the employee identification ca rd to the Board during the pendency of such charges.
10. Licensee and employee agree this prospective employee is not authorized to act as an employee
for any other bondsman licensee.
11. Employee has read and agrees to comply with all of the provisions of V.T.C.A. OCCUPATIONS
CODE CHAPTER 1704 (THE NAIL BONDING ACT:, and the TOM GREEN COUNTY BAIL BOND
BOARD RULES, as amended. Yes ____ No ____.
12. As of the date of this application, the Bail Bond Licensee responsible for this Employee
Application has no unpaid final judgments of forfeiture in any County in which the licensee holds
or has held a bonding license. True____ Not True ____. If “Not True”, list all unpaid or partially
paid final judgments relating to bail bond forfeitures and entered against the licensee: ________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
6
LICENSEE & PROSPECTIVE EMPLOYEE’S OATH
I, the undersigned Tom Green County Licensee, hereby swears, under penalty of perjury, that
the information contained in this Application For Employee Card is true and correct.
Date: ________________ _______________________________________
Signature of Licensee
_______________________________________
Assumed Name of Licensee’s Business
SWORN AND SUBSCRIBED to before me on this ______ day of ____________________, 20____.
_______________________________________
Notary Public in and for the County of ________
_____________, and the State of ___________
My Commission Expires: ___________________
I, the undersigned Employee hereby swear, under penalty of perjury, that the information
contained in this Application For Employee Card is true and correct.
Date: ________________ _______________________________________
Signature of Prospective Employee
SWORN AND SUBSCRIBED to before me on this ______ day of ____________________, 20____.
_______________________________________
Notary Public in and for the County of ________
_____________, and the State of ___________
My Commission Expires: ___________________
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APPLICATION FOR EMPLOYEE CARD TOM GREEN COUNTY BAIL (Tom Green County)

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Completed 9 August 2020

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