AGREEMENT TO INDEMNIFY For and in consideration of ASAP Bail Bonds, hereinafter referred to as Bonding Company, securing the release (from jail)(DefendantName) _________________________________ Hereinafter referred to as BONDED PERSON, I, (Print Your Name)_______________________________________________, hereinafter referred to as an indemnitor, agree to pay ASAP Bail Bonds the sum of $_________within 5 days of bond forfeiture. In addition to the above indemnitor agrees to pay Bonding Company all reasonable and necessary expenses incurred, if any, therein in attempting to locate, find, attach, arrest, and submit Bonded Person as a result of the bond forfeiture. The indemnitor understands that if further explanation is necessary as to meaning of bond forfeiture, ______________ of ASAP Bail Bonds will explain it before the indemnitor should sign this agreement. ASAP Bail Bonds has the right to terminate this agreement at anytime. I also herby grant permission to ASAP Bail Bonds or its representative to contact, investigate, and/or obtain information from my employer credit references, and/or credit bureaus during the term of this agreement. I have fully read this agreement, acknowledge and have understanding of a bond forfeiture, and agree to its terms and conditions. Dated the _______day of________________, 2016. _______________________________ Principal/Indemnitor PROMISSORY NOTE Promise To Pay Holder of This Note On Demand For valuable consideration, the receipt and sufficiency of which is hereby acknowledged, on demand, we and each of us (hereinafter called Principal), jointly and severally, promise to pay to Derrick Dixon. d/b/a ASAP Bail Bond Company in his capacity as an agent of Lexington National Insurance Corporation. or bearer (herein called Holder), the sum of $ ____________, in US Dollars, together with interest at the rate of ten (10) percent per annum on the principal sum twice the amount of bond from the date shown above, payable at: 104 MAIN ST. HOUSTON, TX 77002 Houston, Harris County, Texas. Initials x_____ Waiver of Rights By Principal By signing this Note, each Principal of this Note expressly waives demand, grace, notice to intent to accelerate, notice of acceleration, protest, and presentment for payment, and further agrees that this Note may be renewed, and the time for payment extended without notice, and without releasing any of the parties. All Costs of Collection Shall Be Paid By Principal On Demand Each Principal of this Note shall pay on demand all costs of collections, legal expenses, and attorney’s fees incurred or paid by the Holder in collecting or enforcing this Note. A waiver on any one occasion shall not be construed as a bar to or waiver of any right or remedy on any future occasion. Definitions As used in this Note, this term “Principal” means each of the undersigned. If this Note is signed by more than one in the capacity of Principal, it shall be the joint and several liabilities of these persons. The term “Holder” means the Payee or other endorsee of this Note who is in possession of it, or bearer of this Note. ______________________________________ _______________________________________ Signature of Indemnitor (Principal) Signature of Co-Indemnitor (Principal) ______________________________________ _______________________________________ Printed Name Printed Name ______________________________________ _______________________________________ Address Address ______________________________________ _______________________________________ Telephone Number Telephone Number ______________________________________ _______________________________________ Social Security/Drivers License # Social Security/Drivers License # ______________________________________ Signature of Defendant (Principal) ______________________________________ Printed Name ______________________________________ Address ______________________________________ Telephone Number ______________________________________ Social Security/Drivers License #

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Signed by Todd Holmes
Signed On: January 17, 2017

Signature Certificate
Unique Document ID: 406939f5002cebfc681a1ea02104af2f0297eb78
Timestamp Audit
2017-01-17 21:13:56 EDT IMDEMNITOR APPLICATION Uploaded by Todd Holmes - IP,