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Home
Who We Are
What We Do
- Insurance
  - CLIPs
  - SURPLUS LINES FRONTING
- Surety
Blog
Payment
Claims
- BMC-84 Freight Broker Bond Claims
- General Surety Claims
Contact Us

Large Bond Approval Form

LARGE BOND APPROVAL FORM ENTRY

Please fill out the following form and submit for approval.

If you do not receive a telephone call reply to your submission within fifteen minutes, please contact us immediately by telephone.

Defendant *

Bondsman *

Amount *

Bondsman Phone Number *

Power # *

Email* *

Jail/Jurisdiction *

Incarceration Date *

Charges *

Potential Punishment *

Prior Convictions *

Prior Jail Time* *

Facts related to arrest/charges *

When Arrested *YesNo

Private Lawyer *YesNo

Retainer Paid to Lawyer *YesNo

Social Security No. *

Gender *MaleFemale

U.S. CitizenYesNo

Next Court Date*

Expected Duration of Bond *

Defendant's DOB *

Born (City) *

Raised (City) *

Length of residence in current city *

Education/Trade *

How long? *

Employment* *

Length of current employment *

Current Home Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal code

Country

Own home? *YesNo

Living with?

Married?

Spouse's name

Spouse's occupation

Length of marriage

Children?If yes, enter the information below. If no leave it blank.

Child's Name #1 First Name

Child's Name #1 Last Name

Child's Name #2 First Name

Child's Name #2 Last Name

Child's Name #3 First Name

Child's Name #3 Last Name

Child's Name #4 First Name

Child's Name #4 Last Name

Parents Living?If yes, enter the information below. If no leave it blank.

Father First Name

Father Last Name

Mother First Name

Mother Last Name

Siblings?If yes, enter the information below. If no leave it blank.

Sibling's Name #1 First Name

Sibling's Name #1 Last Name

Sibling's Name #2 First Name

Sibling's Name #2 Last Name

Sibling's Name #3 First Name

Sibling's Name #3 Last Name

Sibling's Name #4 First Name

Sibling's Name #4 Last Name

Other Relatives #1 First Name

Other Relatives #1 Last Name

Other Relatives #2 First Name

Other Relatives #2 Last Name

Previously Bailed by Agent? *

FTA History

Who paying premium? *

In Full or Over Time? *

Defendant Check-In Required? *YesNo

GPS Anklet or Other Conditions

Notes

Indemnitors

Indemnitor #1 First Name

Indemnitor #1 Last Name

Indemnitor #1 Relationship

Indemnitor #1 Annual Income

USD

Indemnitor #1 Occupation

Indemnitor #2 First Name

Indemnitor #2 Last Name

Indemnitor #2 Relationship

Indemnitor #2 Annual Income

USD

Indemnitor #2 Occupation

Indemnitor #3 First Name

Indemnitor #3 Last Name

Indemnitor #3 Relationship

Indemnitor #3 Annual Income

USD

Indemnitor #3 Occupation

Indemnitor #4 First Name

Indemnitor #4 Last Name

Indemnitor #4 Relationship

Indemnitor #4 Annual Income

USD

Indemnitor #4 Occupation

Indemnitor #5 First Name

Indemnitor #5 Last Name

Indemnitor #5 Relationship

Indemnitor #5 Annual Income

USD

Indemnitor #5 Occupation

Collateral

Property Location (1)

Owner

FMV

1st Lien

2nd Lien

100% Equity

80% Equity

Documentation Checklist

Completed Bail Bond Application *YesNo

Completed Indemnity Agreements *YesNo

Property Collateral

Deed of Trust/Mortgage *YesNo

Evidence of Property Value (Tax Assessment, Appraisal, DataQuick, etc)? *YesNo

Evidence of Liens (title work, mortgage statement, etc)? *YesNo

Please do not fill in this field.

By clicking here, I agree to be contacted at the number or email provided

888-888-2245

410-625-0800

Lexington National Insurance Corporation
11426 York Road, 2nd Floor
Cockeysville, Maryland 21030

Copyright © 2024. Lexington National. All Rights Reserved.

Website design by Reflective Matrix

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Surety Bonds

Contract Surety Commercial Surety

Validate a Bond

First Name *

Last Name *

Email Address *

Phone *

Bond Number *

Principal *

Obligee *

Name as it appears on the bond *

Comments

Please do not fill in this field.

CONTACT OUR Executive TEAM

Ronald Frank

rfrank@lnic.com
John Dykstra

john@lnic.com
Phyllis Frank

phyllis@lnic.com
Randy Parton

randy@lnic.com
Mark Holtschneider

mark@lnic.com
Kim Marzullo

kim@lnic.com
Robin Frank

robin@lnic.com
Lisa Slater

lisa@lnic.com
Scott Williams

scott@lnic.com
Susan Jordan

susan@lnic.com

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