Acceptable Person ApplicationBail Security Agreement

Bail Act 2013

Case number:

Accused Person Details

Name of accused:

Amount required:

Acceptable Person Details

Name:

Address:

Email address:

Occupation:

Date of birth:

I apply to be considered as an acceptable person to enter a bail security agreement under the Bail Act 2013.

I understand that should any answer that I have given in this document be untrue or wilfully misleading that I may be charged with a criminal offence.

I further understand that if the accused person fails to comply with any condition of his/her bail acknowledgement, then the money/security that I am depositing or agreeing to forfeit may be forfeited to the Crown, and, if I wish to be discharged from my obligation under the bail security agreement, I must apply to a court which will hear my application.

Part A – Questionnaire (must be completed)

How long have you known the accused person?years/months

What is your relationship to the accused?

Have you been charged or convicted of any criminal offences? (if yes, please provide details of offence(s):

Do you have any criminal charges (including court attendance notices) outstanding? (if yes please provide details of offence(s):

Have you previously been named a debtor in any bankruptcy proceedings? (if yes, please provide details including dates, name of creditor and if you have been discharged):

Are you currently subject to any bankruptcy orders? (if yes, please provide details):

Do you have any bankruptcy proceedings pending?(If yes, please provide details including name of creditor and date of next appearance):

Are you currently subject to any Debtor Agreements?(If yes, please provide details including name of creditor, amount owing and the payment arrangement):

Are you currently subject to any debt recovery action? (E.g. Garnishee order, judgment debt)(If you answered yes, please provide details including amount owing, name of creditor, court and any payment arrangement):

Are you currently a bail guarantor in any other matters? (If yes, provide details including name of accused, court, next appearance date):

Part B – Complete if security is not required to be deposited

Provide full details of your financial resources to pay the amount required should the accused person fail to comply with the bail undertaking (e.g. Amount held in bank accounts, furniture, etc.):

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Part C – Complete if security is required to be deposited

Provide details of the security that you propose to lodge (e.g. cash, land, other – please specify):

If cash is to be lodged, is this your money? (circle) Yes / No

Provide details of where the cash was obtained from (For return of security lodged, enter details at Part D):
I solemnly and sincerely declare and affirm that the answers that I have given in this document are true and correct to the best of my knowledge, information and belief.
Signature of acceptable person:
Date:

Part D – Return of security lodged

Where security is lodged in cash and is to be returned, the cash will be returned by cheque or by electronic funds transfer into a bank account. (NOTE: Where security is lodged in a form other than cash, the acceptable person must arrange to collect it from the Court where it is held) Please complete the following election as to the return type:

Name:

Address:

Email:

Return of deposit (tick one below)

I request the cash be returned by cheque – posted to the address shown

I request the cash be returned by electronic funds transfer to the following bank account

Account Details

Bank:

Branch:

BSB number:

Account name:

Account number:

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