Fillable TOM GREEN COUNTY BAIL BOND INDIVIDUAL SURETY LICENSE (Tom Green County)

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TOM GREEN COUNTY BAIL BOND INDIVIDUAL SURETY LICENSE (Tom Green County)

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Application for Individual Surety License Page 1
TOM GREEN COUNTY BAIL BOND
INDIVIDUAL SURETY LICENSE APPLICATION
**Submit Original & 14 Copies with filing fee to Tom Green County Treasurer**
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 THE BOARD HAVE BEEN FULLY COMPLIED WITH.
Applicant Name ________________________________________________________________________________
FOR BOARD USE ONLY
DO NOT WRITE BELOW THIS LINE
____________________________________________________________________________________________________________________
Application Received by: ___________________________________Date:__________________________________
$500.00 Fee Receipt Attached? (Circle One) YES / NO
Assumed Name (DBA) filed on Record with Tom Green County Clerk: _____________________________________
Outstanding un-satisfied forfeitures of judgments in any County: ________________________________________
Conditionally Approved / Denied Date: __________________________
Security properly filed and in proper form on: ______________________Received by: _______________________
Application Final Approval Granted by Board and License Issued on: ______________________________________
LICENSE NUMBER: ____________________ DATE EXPIRES: ___________________________
_____________________________________________________________________________________________
New Application _____
Renewal Application _____
Application for Individual Surety License Page 2
CHECKLIST OF DOCUMENTS REQUIRED AT TIME OF SUBMISSION
FOR APPLICATION TO BE CONSIDERED BY THE BOARD
INCOMPLETE APPLICATIONS WILL BE DENIED LICENSURE
_____ A. A completed original application.
_____ B. The $500.00 application fee made payable to the Tom Green County Bail Bond
Board.
_____ C. A complete and sworn financial statement.
_____ D. A certified copy of the properly filed and currently valid Assumed Name Certificate (DBA) made out in
Applicant’s name.
_____ E. 3 signed original letters of recommendation for the Applicant, specifically identifying the author
of the letter and their relationship to the Applicant, which meet the statutory requirements of the Texas
Occupations Code, Chapter 1704.
_____ F. A signed original letter of good standing from the bail bond board or bonding authority of each Texas
County in which the Applicant has ever been licensed.
_____ G. 2 passport-sized photos of applicant.
_____ H. One full set of Applicant’s fingerprints. If this is a renewal application of a current license, the fingerprint
card currently on file with the Tom Green County Sheriff’s Office is sufficient.
_____ I. A certified copy of the applicant’s Criminal History provided by the Texas Department of Public Safety.
_____J. Designate the form of the $50,000.00 security to be deposited with the Tom Green County Treasurer’s
Office if application is conditionally approved (Circle One):
Cashier’s Check / Cash / Certificate of Deposit / Real Property
_____ K. Proof of completion of at least 8 hours of continuing legal education in criminal law courses
approved by the State Bar of Texas and offered by an accredited institution of higher education in the
state.
_____ L. Submit documentary evidence that in the two years preceding the filing of this Application, Applicant
has been continuously employed for 1 year by a person licensed under Chapter 1704 of the Texas
Occupations Code (example, W-2 forms or check stubs), and that the Applicant was required to work not
less than 30 hours per week (example, timesheets), excluding annual leave, and perform duties in
all phases of the bonding business (example, job description).
Application for Individual Surety License Page 3
_____ M. If Applicant intends to use Real Estate as security, the Application MUST include a Statement listing all
NON-EXEMPT REAL ESTATE owned by the Applicant which is intended to be conveyed in trust to the
Tom Green County Bail Bond Board as security upon tentative approval of the Application. The
following shall be included for EACH parcel:
1) A legal description equivalent to the description required to convey the property by general warranty
deed.
2) Current statements from every taxing unit with power to assess or collect taxes against the property
indicating that there are no un-paid taxes or outstanding tax liens on the property.
3) A sworn statement from the Applicant agreeing to keep all taxes paid on the property while it
remains in trust.
4) A sworn statement from the Applicant agreeing not to further encumber the property after
conveying it in trust to the Tom Green County Bail Bond Board.
5) A sworn agreement from the Applicant that the Applicant will insure, and keep current the insurance
on the property, including all improvements against any damage or destruction for the full amount of
the value claimed for the property and all improvements, while the property remains in trust.
6) A current appraisal made in accordance with Texas Occupations Code, Chapter 1704.155(3).
7) A sworn statement from Applicant’s Spouse, if any, agreeing to the transfer to the Tom Green County
Bail Bond Board, as part of the trust, any right, title, or interest that the Applicant’s Spouse may have in
the property, and that the Applicant’s Spouse will execute deeds of trust to any community property
placed in the security deposit.
8) Documentation of Insurance on the property listing the name of the insurance company to confirm
that the property is properly insured. Along with an insurance policy showing Tom Green County Bail
Bond Board as an additional insured.
Date Application Prepared: ______________________________ (Circle One) ORIGINAL or RENEWAL
If Renewal, the date original license was granted by Tom Green County: ________________________
Current License Number: _______________ ___ Expiration Date: _____________________________
Application for Individual Surety License Page 4
ATTACH PAGES AS NEEDED TO FULLY ANSWER EACH QUESTION
1. Individual Applicant Name: ____________________________________ Age: _____________________
Social Security Number (optional): ___________________________ Date of Birth: ____________________
Driver’s License Number: ____________________________ Driver’s License State: ___________________
Home Address: _____________________________________________________________________________
City, State, Zip Code: _________________________________________________________________________
Home Telephone: _________________________________ Fax: __________________________________
Length of Residence in Texas: _____________ Citizen of the United States: Yes___ No ___
2. Are you married under the laws of Texas or any other jurisdiction? Yes ____ No ____
If “Yes”, Applicant’s Spouse Name:
Date of Birth: Age: Driver’s License No. & State:
Home Address: _____________________________________________________________________________
City, State, Zip Code: _________________________________________________________________________
Home Telephone: _________________________________ Fax: __________________________________
3. Have you or any business of yours ever filed for or been involved in any voluntary or involuntary bankruptcy,
been placed in receivership, been adjudged bankrupt, or been involved in any insolvency proceedings?
Yes ____ No ____ If “Yes”, give full details including date of filing, location, Court, case number, and date of final
judgment:
4. Assumed Name under which this bonding company business shall be conducted (DBA):
__________________________________________________________________________________________
Date DBA was filed with Tom Green County Clerk: _________________________________________________
Business Address: ___________________________________________________________________________
City, State, Zip Code: _________________________________________________________________________
Business Telephone: _________________________________ Fax: __________________________________
5. Will Applicant conduct bail-bonding business at any other locations? Yes _____ No_____
If “Yes”, explain fully giving all addresses and reasons:
6. Will any business other than bail bonding be conducted at the addresses listed in 4 and 5? Yes ___ No ____
If “Yes”, give full details as to other business which will be conducted:
7. Is this business owned, in whole or in part, by any persons (including Corporations) other than the Applicant?
Yes ___ No ____ If “Yes”, give full details for each co-owner or partial ownership interest and attach a copy of all
documents creating such ownership interests:
Application for Individual Surety License Page 5
8. Have you ever been connected in any way with any bail bonding company other than the one for which you are
now applying? (Including ownership, partial interest in, worked for, etc.)? Yes ___ No ____
If “Yes”, give full details including names, nature of connection, and dates:
9. Have you, or any business owned in whole or in part by you, ever been denied or refused a bail bond license 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:
10. Applicant has at least 1 year of continuous work experience in the bail bond business in the 2 years preceding the
date of this application? Yes ___ No ___ List name, address, and telephone number of bonding company,
name of licensed bondsman (or agent, if a corporation), County, and license number, as well as dates of employment:
11. Have you, or any business owned in whole or in part by you, ever had a bail bond license suspended, canceled, or
revoked? Yes ___ No ____ If “Yes”, give full details including County, dates, reasons, etc.:
12. Applicant has completed _________ hours of continuing education classes in the 2 years preceding the date of
this application. List location, date, and name of course(s) attended (Minimum of 8 hours
required):_______________________________________________________________________________________
________________________________________________________________________________________________
_______________________________________________________________________________
13. List all employees and/or agents that are going to work for, or that are now working for, this bail bonding
company, and give their name, date of birth, driver’s license number, and State:
14. Are you, or any business with which you are connected, currently involved in any civil litigation (excluding bond
forfeitures)? Yes ___ No ____ If “Yes”, attach copy of suit and give full details including County, Court, case
number, date filed, and nature of litigation:
15. Have you ever been convicted of any felony or misdemeanor offense, in any Jurisdiction? Yes ___ No ____
If “Yes”, give full details including Jurisdiction, State, County, Court, case number, charge, date of offense, and final
disposition:
16. List all counties in which you, or any business owned in whole or in part by you, now has or has ever had a bail
bond license:
Application for Individual Surety License Page 6
INDIVIDUAL SURETY APPLICANT OATH
I, the undersigned Applicant, do hereby certify that I have personally read and reviewed this application, and I do hereby
state and certify under oath that there are no misrepresentations, omissions, or falsifications in the forgoing statements
and answers including all attachments, and that the entries made above on all attachments are true, complete, and
correct to the best of my knowledge and belief and are made in good faith.
I do hereby request and authorize the Tom Green County Bail Bond Board, or its designee, to make a thorough and
complete investigation of the facts and assertions made within this application in order to confirm their truthfulness or
falsity.
I do hereby request and authorize any person or persons, each former employee or employer, or any firm or corporation
referred to in this application to give any information and answer all questions asked concerning this application as
deemed needed by the Tom Green County Bail Board, or its designee, in the investigation or re-investigation of this
application and its contents.
I hereby agree and consent that in the event that this application is found to contain any false statement, omission of
information, or misinterpretation of any kind, this application will be denied.
In consideration of granting this bail bond license and in order to insure payment of any and all obligations incurred by my
bail bonding business due to this license, I will deposit with the Tom Green County Treasurer, security in the form of one
of the following, or a combination of, that constitutes at least a minimum of the security required under the Tom Green
County Bail Bond Board Rules and Regulations:
• A Certificate of Deposit, drawn on an institution insured by the Federal Deposit Insurance Corporation, in the
amount of $50,000.00 and made payable to the Tom Green County Treasurer, in a form which is acceptable to the
Tom Green County Treasurer and the Tom Green County Bail Bond Board.
• Cash in the amount of $50,000.00.
• A Cashier’s Check, drawn on an institution insured by the Federal Deposit Insurance Corporation, in the
amount of $50,000.00, and made solely payable to the Tom Green County Treasurer, in a form which is acceptable to
the Tom Green County Treasurer and the Tom Green County Bail Bond Board.
• A Deed of Trust to Non-Exempt Real Estate with an appraised value of $50,000.00 or more, as prescribed in the
Texas Occupations Code, Chapter 1704, and in form directed, approved, and acceptable to the Tom Green County
Treasurer and the Tom Green County Bail Bond Board.
Application for Individual Surety License Page 7
I, the undersigned Applicant, do certify that I have read and understand the Tom Green County
Bail Bond Board Rules and Regulations, and Chapter 1704 of the Texas Occupations Code, and I
agree that I, and each of my employees, will comply with and be bound to these laws and rules.
Date: ________________
Signature of Applicant
Typed Name of Applicant
Assumed Name or DBA of Applicant’s Business
Subscribed and sworn to before me this _____ day of ___, 20 __, by _______________________, Affiant.
Notary Public in and for the County of
, and the State of
My Commission Expires:
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Application for Individual Surety License Page 8
PERSONAL FINANCIAL STATEMENT OATH
INDIVIDUAL SURETY APPLICATION
Name
Address
Business DBA
Date of Birth
Married ________ Unmarried ________ Separated ________ Number of Dependents ____________
_________________________________________________________________________________________
Tom Green County Bail Bond Board Members,
For the purpose of obtaining an Individual Surety Bail Bond License from the Tom Green County Bail
Bond Board, I submit to the Board the attached statement of my financial condition as of
______________________, 20____.
Should this application be approved, I further swear that I will notify the Tom Green County Bail
Bond Board, in writing, of any material unfavorable change in my financial condition. In the absence of such notice,
the Board may consider this a continuing statement and substantially correct. The Board is authorized to verify with
other persons any information at any time furnished by me in support of this application. This financial statement
and any other information furnished to the Board shall be your property. The Board is authorized to answer
questions about this financial statement, and to investigate any information obtained from me or any other person
pertaining to my credit or financial responsibilities.
THE PENALTY FOR MISREPRESENTING INFORMATION ON THIS FINANCIAL STATEMENT WILL BE DENIAL OF
A BAIL BOND SURETY LICENSE. WITH KNOWLEDGE OF THIS PENALTY, I HEREBY CERTIFY THAT ALL
INFORMATION PROVIDED IN THIS FINANCIAL STATEMENT AND THE ATTACHED SCHEDULES IS TRUE AND
CORRECT AT THE ABOVE STATED DATE.
SIGNATURE OF INDIVIDUAL SURETY APPLICANT
DATE
Subscribed and sworn to before me this day of ,
20 , by ______________________________, Affiant.
Notary Public in and for the County of
, and the State of
My Commission Expires:
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TOM GREEN COUNTY BAIL BOND INDIVIDUAL SURETY LICENSE (Tom Green County)

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Completed 18 July 2020

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