Bail 2 GO — Compliance Dashboard

2 Jotform SIGN Document ID: 262006362107042 Bail 2 GO KISSIMMEE - ORLANDO - SANFORD Defendant Bond Application CONFIDENTIAL I SECURE LEGALLY BINDING Y FDFS Licensed State Verified RE Allegheny Casualty Surety Provider & 256-bit Encrypted Bank-Level Security & Available 24/7 (833) BAIL2GO a WELCOME H…

Bail 2 GO KISSIMMEE - ORLANDO - SANFORD ) Bail Bond Indemnitor Application CONFIDENTIAL I SECURE I LEGALLY BINDING / FDFS Licensed State Verified Re Allegheny Casualty Surety Provider & 256-bit Encrypted Bank-Level Security • Available 24/7 (833) BAIL2GO _ YOU ARE IN GOOD HANDS Bail 2 GO is a fully …

Indemnitor: Ind Add. Ind Home # Relationship to Def.: IA PN Collateral Explained: Collateral in Amount of Collateral held by Bondsman Condition(s) of Bond: Social Security: _ City: State: Ind Cell # How long known Def.: Mortgagee Deed ($17.00) Cash Check ACF#: Zip: Email : Vessel Title ($75.00 fee) …

No Check-ins Active JACOB HERNANDEZ is scheduled to check-in Weekly Monday's starting 07/20/2026 Next check-in due 07/20/2026 Acceptable types of check-ins are: @ Mobile App Mobile Tracing: Enable Disable Device NOT connected Online Check-in Code:QTUQATJOWD Eula NOT signed Send App Download Link Pri…

Notification Settings Turn Notifications On? Types Notification Settings Turn Notifications On? &JACOB JUSTIN HERNANDEZ (Defendant, Indemnitor) Yes No Appearance Date: N/A Checkin Due Standard Check-In Payment Due : N/A ¿ ELEAMY MERCADO (Significant Other, Caller, Indemnitor, Reference) Yes No

Indemnitor: Ind Add. Ind Home # Relationship to Def.: IA PN Collateral Explained: Collateral in Amount of Collateral held by Bondsman Condition(s) of Bond: Social Security: _ City: State: Ind Cell # How long known Def.: Mortgagee Deed ($17.00) Cash Check ACF#: Zip: Email : Vessel Title ($75.00 fee) …

Bail 2 GO KISSIMMEE - ORLANDO - SANFORD Bail Bond Agreement APPROVED BOND TERMS - OFFICIAL DOCUMENT * YOU ARE IN THE RIGHT PLACE. We know this is hard. Someone you love is in jail and you need answers fast. Bail 2 GO has helped thousands of Central Florida families through this exact moment - and we…

Sunday, July 19, 2026 Bail 2 GO LEAD CAPTURE - (Always required - the person calling in) KISSIMMEE - ORLANDO - SANFORD IGNITE - Underwriting Review You have been assigned this bond intake for underwriting review. All intake data collected by the advisor is pre- filled above. Review everything carefu…

Bail 2 GO KISSIMMEE - ORLANDO - SANFORD Premium Receipt Summary PLEASE REVIEW BEFORE SIGNING Confirm Your Premium Receipt Details Your Bail 2 GO agent has prepared this official Premium Receipt for your review. Please confirm all details below are correct before signing. If anything looks incorrect, do not proceed - contact your agent immediately before continuing. RECEIPT & BOND DETAILS Receipt Number Date Received Office Location / County Producer / Agent Defendant Full Name Total Bond Liability Power Numbers) Case Numbers) Court B2GOAP-003210 Sunday, July 19, 2026 Osceola County (Kissimmee) Pacheco, Xavier JACOB HERNANDEZ $750 AS3K-688794 AS3K-688795 Appearance Date Appearance Time Collateral Received Collateral Receipt Number PAYMENT BREAKDOWN Payment Method Apple Pay Amount Cash Amount Cash App Amount Cashiers Check Amount Cashiers Check Number Money Order Amount Money Order Number Square Link Amount Terminal Amount Zelle Amount ITEMIZED EXPENSES Any Itemized Expenses? Expense Description 1 Expense Amount 1 No Credit / Debit Card (Remote Link), Credit / Debit Card (Remote Link) 200 Expense Description 2 Expense Amount 2 PREMIUM SUMMARY Total Bail Bond Premium Total Expenses Total Premium & Fees Due Prior Premium Payment Total Premium Received Square Link Amount Pending Remaining Premium Balance Balance owed after all payments applied $200 $$O $$200 $0 $$0 $ $$200 PAYER INFORMATION Payer Name Payer Phone Payer Email ELEAMY MERCADO (689) 307-9858 ELEAMY@GMAIL.COM • COURT APPEARANCE REQUIRED The defendant must appear at all scheduled court dates. Failure to appear will result in bond forfeiture. The indemnitor will be held financially responsible for the full bond amount and all associated costs. 4 NON-REFUNDABLE PREMIUM NOTICE The bail bond premium is fully earned upon the defendant's release from custody and is non-refundable regardless of case outcome, including dismissal, acquittal, or any other resolution. This is required by Florida law and the terms of the bail bond agreement. • COMPLAINTS & INQUIRIES - FLORIDA DFS For any complaints or inquiries regarding this bail bond transaction, you may contact the Florida Department of Financial Services, Division of Consumer Services: 200 East Gaines Street, Tallahassee, FL 32399-0322 (877) 693-5236 (in-state) | (850) 413-3089 (all areas) A IMPORTANT If any of the information above is incorrect, do not proceed. Stop immediately and contact your Bail 2 GO agent before signing. Sunday, July 19, 2026 • PREMIUM PAYMENT - PAY VIA SQUARE If your agent has set a Square Link Amount on this receipt, complete your premium payment now using the button below. After paying you will receive a Square confirmation number - you will enter that number on the next page before signing. = Pay Premium Now → Available 24/7 | Secure & Encrypted | Powered by Square | Save your confirmation number - you will need it on the next page before signing Ô PAYING BY CASH, CHECK, OR OTHER METHOD? If you are paying by cash, cashier's check, money order, or another method arranged directly with your agent - skip the Square button above. On the next page enter N/A in the payment confirmation field and proceed to sign. Payer Signature Date 9M Sunday, July 19, 2026 16:43

PRESS HARD YOU ARE WRITING THROUGH FOUR PAPER PLIES Only the original Power of Attorney will bind this surety. POWER OF ATTORNEY Allegheny Casualty Company POWER AS3K-688795 NUMBER PO Box 5600, Thousand Oaks, CA 91359 THIS POWER VOID IF NOT USED BY: (800) 935-2245 December 3. 2026 poa@aiasurety.com …

4441 1 11 1111 PRESS HARD YOU ARE WRITING THROUGH FOUR PAPER PLIES Only the original Power of Attorney will bind this surety. POWER OF ATTORNEY Allegheny Casualty Company POWER NUMBER AS3K-688795 PO Box 5600, Thousand Oaks, CA 91359 (800) 935-2245 THIS POWER VOID IF NOT USED BY: December 31, 2026 po…