UNITED STATES DISTRICT
COURT
SOUTHERN DISTRICT OF
FLORIDA
Case
No.
UNITED STATES OF AMERICA
Plaintiff,
vs
/
Defendant
MOTION FOR DISBURSEMENT OF BOND
Comes now the undersigned and respectfully states to this Honorable Court that the above named
defendant has complied with all conditions of the appearance bond in this case, and it is therefore
requested that the defendant’s case bail heretofore posted by
in the amount of $ plus any accrued interest be refunded to:
(Name of Payee. Do NOT include a Mailing address. A notarized assignment is requested if the payee is
different from the person posting bond.)
(The above payee must complete an Internal Revenue Service Form W-9 or if the payee is a nonresident alien
individual, they must complete a Form W-8, either of which may be obtained from the Clerk’s Office Financial
section or internet. The completed form should be provided to the Financial Section, but not filed in the Court file.
Checks will be mailed to the address indicated on the completed form, unless directed in writing otherwise.)
(Petitioner or Attorney)
Consented to by:
Assistant U.S. Attorney
ORDER
In consideration of the forgoing motion, it is thereupon
ORDERED that the Clerk of this Court forthwith make the above-mentioned disbursement.
DONE AND ORDERED at , Florida, this
day of
, 20_
.
UNITED STATES DISTRICT JUDGE
c: U.S. Attorney
Petitioner/Counsel of Record
Financial Deputy Clerk (w/original W-8 or W-9)
PRINT NAME- Assistant U.S. Attorney
