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BAIL BOND APPLICATION - INDEMNITOR COMPANY ALLEGHENY CASUALTY COMPANY P.O. Box 9810, CALABASAS, CA 91372-9810 TELEPHONE (800) 935-2245 Bail 2 GO Kissimmee (Osceola County) 120 Simpson Rd Ste A Kissimmee, FL 34744 (407) 483-7983 1. Name _ First Middle Last My friends/family know me as 2. Residence Address 4054 Sunny Day Way 3. How Long at Current Address Rent Free 4. Is Mortgage/Lease in your name? Yes No 5. Cell Phone # Cell Carrier 6. Employer Length City. Lease _ Own_ When does Lease Expire iPhone or Android Position Kissimmee _ State Landlord/Mortgagor Name _Email FI _ Zip How Long with Cell No. Any ownership greater than 20% in any Corporation, LLC, or S-Corp 7. Social Security No. ID# _ Wt 8. Have you ever filed Bankruptcy. Do you have any judgements or liens against you currently Work # Any specialized license to work _ Ht. _Race . Eye Color If so, where 34744 _Hair 9. Gender Place of Birth Date of Birth US Citizen Marital Status How Long 10. Have many years have you lived in FL? 11. Vehicle Year Vehicle Color Are you a convicted felon? Are you on any type of Probation or Parole ? Vehicle Make Tag No. Vehicle Miles Amount Owed 12. Relationship to Defendant How long have you known Defendant Defendants Home Address Defendants Cell Phone Number 13. Emergency Contact Name Address Phone No. 13. Children Yes No Amount of children Ages Do kids reside with you 14. Attorney Phone No. May we reach out on the defendants behalf 15. How did you hear about us? Personal References First & Last Name Relationship City / State Phone 1._ 2. 3. 4. 5.- 6. Warning: Any person who knowingly and with intent injure, defraud or deceive any insurer, files a statement of claim or an application containing and false, incomplete or misleading information is guilty of a felony of the third degree. Indemnitor Sign Print Jose Lopez ID# SSN DOB CO allegheny CASUALTY COMPANY PO Box 5600, Thousand Oaks, CA 91359 800.935.2245 info@aiasurety.com THIS IS A DOUBLE SIDED DOCUMENT READ ALL SIDES CAREFULLY BAIL BOND AGREEMENT ("Agreement") PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE: Bail 2 GO Kissimmee (Osceola County) 120 Simpson Rd Ste A Kissimmee, FL 34744 (407) 483-7983 In consideration of Allegheny Casualty Company ("Surety"), through Surety's duly appointed independent bail producer ("Bail Producer"), (Surety and Bail Producer are sometimes together referred to as "Surety"), issuing, or causing to be issued, a criminal appearance bail bond described as: Date Defendant Name 9/25/25 JOSE ANTONIO LOPEZ Indemnitor Name(s) Jose Lopez Total Bond Amount $ $ 18,000.00 Total Premium $ $ 1,800.00 Power Number(s) AS3K-TBK ("Bond") I/we represent and warrant that I/we have read, approve and agree to all of the terms and conditions found on following pages (front and back). Signed, sealed and delivered this Defendant Signature 9/25/25 Print Name JOSE ANTONIO LOPEZ Indemnitor Signature Print Name Indemnitor Signature Print Name Indemnitor Signature Print Name Jose Lopez Indemnitor Signature Print Name Indemnitor Signature Print Name Si no puede leer ni entender Inglés, favor de marcar este cuadro. (If you cannot read or understand English, please check this box.) Check box and complete the following if translation is required Translation Certification. The undersigned translator makes this affidavit and hereby certifies, under penalty of perjury, that he/she read verbatim and translated this entire document, including the reverse side, and all related bond application documents including disclosures, promissory notes, security instruments and trust deeds, to the Indemnitor signing below in his/her primary language. Translator Print Name Translator Signature Translator Full Address Date Confirmo por mi colocación de mis iniciales que las dos caras de este acuerdo han sido traducidos completamente a mi satisfacción. (I confirm by my affixing my initials that this contract has been translated to my satisfaction.) INDEMNITOR Initials READ ALL TERMS AND CONDITIONS ON THE FRONT AND BACK OF EACH PAGE Form# ACC.FL.0307 (10/21) +0 8L15, Page 1 of 4 Terms And Conditions You, the undersigned (referred to herein as "Indemnitor," "Defendant," or together as "you" or "your," as applicable), agree to be bound to the following terms and conditions: 1. The premium for the Bond is fully earned upon the release of Defendant from custody. The premium is not refundable except as stated herein or provided by law. The fact that Defendant may have been improperly arrested, the bail reduced, or the criminal case dismissed shall not obligate the Surety to return the premium, or any portion of it. 2. Detendant agrees to appear in any Court as required in connection with the Bond at the dates and times stated in the Bond and/or as may be ordered by the Court. Indemnitor will ensure that Defendant appears in Court as so required or as ordered by the Court. . Surety shall have control and jurisdiction over the Detendant during the term for which the Bond is in ettect and sha lave the rant to apprenend. arrest and surrender the Detendant to the proper otticials at anv time as provided ov lav and/or this Agreement. It the Detendant is surrendered betore a tailure to appear in Court, and tor a reason other than as stated in paragraph 4, , you may be entitled to a refund of the Bond premium if required by applicable law (if any) and as may be stated in the Supplemental Terms and Conditions. 4. Unless otherwise provided by applicable law (it any), the tollowing events shall constitute a breach of vour obligations to the Surety, and the Surety shall have the right to immediately apprehend, arrest and surrender Defendant to custody, and you shall have no right to the refund of premium whatsoever: a Detendant departs the jurisdiction of the court without the prior written consent of the Court and the Surety ) Detendant moves trom his/her current address without prior written consent of the Suretv, or Detendant tail o notity Surety ot any changes in address; (C) Detendant commits any act that constitutes reasonable evidenc t the intention to cause a torteiture of the Bond or Detendant's tailure to appear in Court as required; (d Defendant is arrested and incarcerated for an other offense (other than a minor traffic violation); (e) Defendant or an Indemnitor makes any materially talse statement in any material submitted to Surety for the Bonc ncluding the Bail Bond Application and Indemnitor Application; (f The bail for Defendant is increased; (g Indemnitor requests the surrender to custody of the Defendant; and/or (h) There is a material increase in the risk assumed by the Surety (as determined by the Surety in its sole and absolute discretion), including, by way of example, but not limited to, depreciation or impairment of any collateral pledged as security for the Bond. 5. In the event that the apprehension and surrender of Detendant to custody is required tor any reason, includina the failure to appear by Defendant at any required Court proceeding or hearing, and acknowledges that such apprehension and surrender involves risk of harm to Detendant and others, and as such Defendant accepts the risk of such harm that may be caused to Defendant and/or others. Defendant also agrees to defend, indemnify and hold Surety harmless (including all agents and employees thereof) from any injuries harm osses, claims, actions, lawsuits, damages, liability, demands, fees and expenses, including attorneys fees and costs made by any third party against Surety (including all agents and employees thereof) arising out of such apprehension and surrender of Defendant. 6. You, jointly and severally (together and separately) with any other indemnitor, shall indemnify the Surety and keep the Surety indemnified and hold it harmless from and against any and all claims, lawsuits, damages, losses, liability, demands, actions, judgments, fees, fines, penalties and expenses (including attorneys fees and costs), relating to, arising out of, Surety's issuance or procurement of the Bond (together, "Liabilities"), including, but not limited to, the following: a) the principal amount of any forfeiture of, or judgment on, the Bond, plus any related court costs, interest anc egal fees incurred; (b) any fugitive recovery fee if there is a forfeiture of the Bond (which fee is typically ten t wenty percent 10-20% of the amount of the Bond plus any out of pocket expenses); c any and all cost ncurred to extradite and/or apprehend and return Defendant to custody; and/or (d) if a collection action is requires under this Agreement, reasonable and actual attorney's fees plus any and other costs, expenses and/or assessments that may be incurred as a result thereof the forfeiture of the Bond as subject to applicable law (if any). The voucher, check or other evidence of any payment made by Surety shall be conclusive evidence of such payment in anv action against vou as to the proprietv of such pavment and as to the extent of vour liabilitv to Suretv tor such payment hereunder. -urther, you will, upon demand, place with Surety the requisite cash funds to meet any Liabilities (including a pendin inpaid judgment or forfeiture demand), whether the demand is made before or after Surety has paid or advanced suct 7. Subject to applicable law (it any), any collateral (real or personal, including cash or securities) pledged to or deposited with Surety as security for the obligations under this Agreement ("Collateral" the Bond and/or to place the Surety in cash funds so as to protect the Surety also with the right to purchase said Collateral at such sale or sales, freed and discharged from any equity or redemption, except as otherwise provided by applicable law. 8. The Surety shall not be liable for the depreciation of any Collateral or for any interest thereon. In the event of depreciation of the value of Collateral, or any part thereof, or of any Collateral that may be hereafter pledged to or deposited with the Surety, upon request of the Surety, you shall provide the Surety with additional and satisfactor Collateral so that the total value of the Collateral shall equal the value of the Collateral at the time of the initial pledge or deposit. Subject to applicable law (if any), if you fail to deposit such additional Collateral, the Surety shall have the full 9. If a Confession of Judgment ("COJ") is taken as security for the Bond, the Surety shall have the right to enter, record and file the COJ at any time, and such COJ shall constitute a lien entitled to a preference against any of your property, Form# ACC.FL.0307 (10/21) Page 2 of 4 whether or not the Surety is entitled to be indemnitied at the time of the entry, recording or tiling of such COJ. It such COJ is entered, recorded or filed by the Surety against you, the COJ entered shall be effective and available to the Surety against you. 10. You acknowledge and agree that the Surety may foreclose against the Collateral and/or exercise any of the rights or remedies_provided under this Agreement or take any combination of such actions without waiving any other right or remedy. Failure to exercise any rights or remedies of the Surety at any one time shall not constitute a waiver of the right to exercise them at any other time. Any security or Collateral you give may be substituted, subordinated, or released by the Surety without affecting any other rights. The Surety shall not be obligated to enforce its rights against any security, Collateral or indemnitor prior to enforcing its rights against you or any other indemnitor. 11. Subject to applicable law (if any), the Surety will return the Collateral to you when all of the following are satisfied: (a) the Surety receives sufficient and competent written legal evidence satisfactory to the Surety (for example, written notice from the Court) of the discharge, release or exoneration of the Surety from all liability under the Bond; (b) there are no outstanding Liabilities of any kind arising out of or relating to the Bond or this Agreement; c) there are no other obligations executed by, for or on behalf of the Defendant for which the Surety may deem t advisable to retain such Collateral for its protection; and (d) upon the request by Surety, you shall execute anc deliver to Surety a legal release of claims upon the return by Surety of the Collateral to you. f the Surety deems it necessary to make any outlay to protect any Collateral or security in its possession, whether foi real or personal property, you authorize the Surety to do so, and vou agree to indemnity and reimburse the surety to any such outlay as in the judgment of the Surety may be necessary to protect the Collateral, including payment of taxes, liens or mortgages and any attorney's tees, costs and service tees tor time spent and/or special services rendered. 12. The Surety shall have the right to transfer and/or assign, in whole or in part, its rights and obligations in this Agreement, and/or in the Bond, to the Bail Producer or any other person or entity ("Assignee") without notice to or Assignee shall have the right to one anen on one are her one out a no and yes awe any aro, ner earn or rene, that Assignee does not have the right to enforce such rights in any such action, proceeding or otherwise. 13. You hereby acknowledge and agree that neither the Surety nor Bail Producer has recommended or suggested any specific attorney or firm of attorneys to represent the Defendant in any capacity 14. This Agreement may not be terminated or modified orally. Any modification and termination of this Agreement, including any release of liability hereunder, must be in writing and signed by the Surety and you. federal law (including, but not limited to, Title 28, Privacy Act-Freedom of Information Act and Title Reporting Act) and any local or state law relating to Surety obtaining, and vou consent to and authorize Surety to obtain, any and all private or public information and/or records concerning you from any party or agency, private or governmental (local, state or federal), including, but not limited to, credit reports, Social Security Records, criminal records, civil records, driving records, tax records. telephone records, medical records, school records, worker compensation records, and employment records. You further authorize, without reservation, any party or agency, private or governmental (local, state or federal) contacted by Surety to furnish to Surety or Bail Producer, in accordance with applicable law, any and all private and public information and records in their possession concerning you to the Surety and direct that a copy of this document shall serve as evidence of said authorization. 16. You irrevocably grant to Surety and Bail Producer, and their agents and employees, the right to enter your residence, or any other residence or real property you own or occupy, without notice, at any time, for the purpose of ocating, arresting, and returning the Detendant to custody, and subject to applicable law, you waive and release any and all causes of action in connection therewith, including without limitation, torts of trespass and false imprisonment. 17. Defendant agrees that Surety may attach a location tracking device on any vehicle owned or driven by Defendant, at any time, without notice, and monitor the location of the vehicle through any available technology. Defendant further agrees that Surety may use location technologies to locate and track any wireless device of Defendant at any time during the period of the Bond is in force and any applicable Bond remission period, and the Bond is conditioned upon the full compliance by Defendant with the following terms and conditions: a) Surety, at its discretion, will use network-based location technologies to locate Defendant; (b) This is the only notice Defendant will receive for the collection of location information; (c) Surety will retain location data only while the Bond is in force and during any applicable Bond remission period; (d) Surety may disclose location I POU UP A 100 TRACKING DURNE THE PERIOD THE BOND IN FORCE AND ANY APPLICABLE BOND REMISSION PERIOD. Direct all questions regarding this paragraph to the Surety. 18. If Defendant leaves the state in which the Bond was issued, subject to applicable law, Defendant waives any rights to oppose extradition proceedings. 19. In the event any provision herein shall be deemed to exceed any applicable state or federal law, then such provision shall automaticallv be deemed to have been revised to comply with such law so as to provide Surety with the maximum rotection from any Liabilities. The invalidity or unenforceability of any provision herein (or portion thereof) shall in no way effect the validity or enforceability of any other provision (or portion thereof) of this Agreement 20. This Agreement and all documents that are executed in connection with this Agreement set forth all the terms of the of no force or effect whatsoever in determining the rights, obligations and/or liabilities between the Surety and you. You further agree to execute and be bound by any other future documents necessary to carry out and effectuate this Agreement. Form# ACC.FL.0307 (10/21) Page 3 of 4 1. Surety, as bail, shall have control and jurisdiction over Defendant during the term for which the Bond is executed and shall have the right to apprehend, arrest and surrender Defendant to the proper officials at any time as provided by law. 2. In the event Defendant's surrender is made prior to the time set for Defendant's appearances, and for reasons other than as enumerated below in paragraph 3, then a refund of the Bond premium shall be made to the person whose name appears as Payer on the Premium Receipt. . It is understood and agreed that the happening ot any one of the tollowing events shall constitute a breach o etendant's obligations to Suretv, and Surety shall have the right to immediately apprehend, arrest and surrende and no person shall have any right to any refund of premium whatsoever. The events which constitute a breach of Defendant's obligations hereunder are: a It Detendant departs the jurisdiction of the Court without the written consent of the Court and Surety or Bal Producer; (b) If Defendant moves from one address to another within the State of Florida without notifyinc Surety or Bail Producer in writing prior to moving; (c) If Defendant commits any act which constitutes reasonable evidence of Defendant's intention to cause a forfeiture of the Bondi(d) If Defendant is arrested and incarcerated for any offense other than a minor traffic violation; or (e) If Defendant makes any material false statement in the 4. INFORMATIONAL NOTICE. For any complaints or inquiries, you may contact the Department of Financial Services Division of Consumer Services, Section, East Gaines Street, Tallahassee, FL 32399-0322, 1-877-693-5236 (in-state) 5. The person whose name appears as Payer on the Premium Receipt shall be entitled to a refund of premium for the Bond if and when it is found that Surety had no liability under the Bond because Defendant did not come under the jurisdiction of the court to which Defendant is returnable or Defendant is not released from custody, except where the Bond is written to allow Defendant to serve a sentence in another jurisdiction. 6. For good and valuable consideration, you agree to indemnify and hold harmless the Surety or its agent for all losses not otherwise prohibited by law or by rules of the Department of Financial Services. 7. You acknowledge receipt of copies of this Agreement, which includes statements as to () the restrictions placed or Defendant as a condition of the Bond and (b) the Bail Producer's and Surety's powers relating to the cancellation of the Bond and recommitment of Defendant. 8. The specific fees for which you are required to indemnify Surety in accordance with the Agreement are as follows: (a) Costs necessary to apprehend Defendant in the event Defendant attempts to flee the jurisdiction of the courts; (b) Attorneys tees and court costs associated with tiling of motions; (c) Documented transportation and lodging expenses outside the jurisdiction of _aw enforcement costs for housing, transportation and extradition; and (e) A maximum fee of $100 for a surrender allowed by law when there has been no forfeiture of the Bond 9. Collateral will be returned to the person whose name appears as "Depositor" on the Collateral Receipt within 21 days after proof of final termination of liability on the Bond has been provided to the Surety. entitled to deduct from collateral held or any return authorized by applicable law, including Fiorida Administrative Code 69B-221 Premium all fees, expenses, and charges a conflict between the terms and conditions of the Agreement and this Supplement shall control. Form# ACC.FL.0307 (10/21) Page 4 of 4 allegheny CASUALTY COMPANY PO Box 5600, Thousand Oaks, CA 91359 800.935.2245 info@aiasurety.com BAIL BOND INFORMATION SHEET PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE: Bail 2 GO Kissimmee (Osceola County) 120 Simpson Rd Ste A Kissimmee, FL 34744 (407) 483-7983 Defendant Name JOSE ANTONIO LOPEZ Power Numbers) Case Number 25CF3044 AS3K-TBK As principal (detendant) and/or indemnitor (guarantor) on a bail bond, you must be given a copy of any collateral documents that you sign relating to the above bond(s) When all agreements have been fulfilled, bond is discharged in writing by the court, and without loss expense on the bond(s), your collateral will be returned to you. BE AWARE: YOUR COLLATERAL IS AT RISK if the principal fails to appear in court or if the principal commits any breach (violation) of agreement. ANY OF THE FOLLOWING HAPPENINGS IS A BREACH OF AGREEMENT: 1. If principal fails to appear in court; 2. If principal shall depart the jurisdiction of the court without the written consent of the court and the Surety, or its agent; 3. If principal shall move from one address to another without notifying the Surety, or its Agent, in writing, prior to said move; 4. If principal shall commit any act which shall constitute reasonable evidence of principal's intention to cause a forfeiture of the bond(s); 5. If principal is arrested and incarcerated for any offence other than a minor traffic violation; 6. If principal shall make any material false statement in the application; 7. If principal shall violate any special restriction or condition of the bond(s) imposed by the Court. For general information regarding your collateral, contact the agency as shown on the top of this sheet. For further inquiry / complaint, contact Department of Financial Services Bail Bond Section 200 East Gaines Street Tallahassee, FL 32399-0320 Phone: (850) 413-5660 **** Read carefully prior to signing **** PRINCIPAL/INDEMNITOR ACKNOWLEDGMENT I/We have received a copy of this information sheet. INe have received a copy of all collateral documents that I/e signed regarding the above bond(s). Defendant Signature Indemnitor Signature Print Name Date Print Name Jose Lopez Signed original to agent's bond file; Copy to defendant and each indemnitor Date 9/25/25 Form# ACC.FL.0028 (10/22) Page 1 of 1 CONTINGENT PROMISSORY NOTE This Contingent Promissory Note ("Note") is being executed by the undersigned ("Maker") to secure Allegheny Casualty Company, as Surety, upon forfeiture or estreature of the surety bond(s) posted on behalf of defendant: JOSE ANTONIO LOPEZ ("Defendant"). On demands after date, for value received, I/We promise to pay to the order of Allegheny Casualty Company the sum of $ $ 18,000.00 Dollars, at PO Box 5600, Thousand Oaks, CA 91359, with interest thereon at the rate of eighteen percent (18%), per annum from call date until fully paid. The Maker further agrees to waive demand, notice of non-payment and protest, and in case suit shall be brought for the collection hereof, or the same has to be collected upon demand of an attorney, to pay reasonable attorney's fees and assessable costs, for making such collection. It is further agreed and specifically understood between the parties to this Note that there is presently no outstanding loan or debt represented by this Note, and that this Note is given only to secure future advances. It is further agreed and specifically understood that this Note shall become null and void in the event the said Defendant shall appear in the proper court at all the time or times so directed by the Judge or Judges of competent jurisdiction until the obligations under the appearance bond or bonds posted on behalf of the Defendant have been fulfilled and the Surety discharged or exonerated of all liability thereunder, in writing, otherwise to remain in full force and effect. Case number(s) 25CF3044 OSCEOLA COUNTY, FLORIDA P/A numbers) AS3K-TBK Signature Jose Lopez Maker Name Form# ACC.FL.0036 (10/21) Signature 9/25/25 Date Reset Form COLLATERAL RECEIPT allegheny CASUALTY COMPANY PO Box 5600, Thousand Oaks, CA 91359 800.935.2245 info@aiasurety.com • Deposit of collateral: Depositor hereby acknowledges receipt of a copy of this document and agrees to the terms on the reverse side. The collateral identified below is deposited as security for the bail bond(s), premium owed, if any, and all lawful expenses incurred due to underwriting the referenced bail bond(s). Date Received 9/25/25 Depositor Name(s) Jose Lopez Depositor Address 4054 Sunny Day Way Power Numbers) AS3K-TBK Items) Received - describe below, specify condition Promissory Note, Signature Bail Bond Agreement Collateral funds - in form of Signature & Mortgage Deed If applicable, I acknowledge a Credit Card fee of Signature FLORIDA USE ONLY Form# ACC.FL.0304-2 (01/23) Depositor Print Name Jose Lopez Receipt No.: ACFL- 0924252023 PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HER Bail 2 GO Kissimmee (Osceola County) 120 Simpson Rd Ste A Kissimmee, FL 34744 (407) 483-7983 L Return of collateral: Depositor hereby surrenders the original and acknowledges the return and receipt of collateral listed herein and that the collateral has been returned in good and sufficient condition. Depositor hereby relieves the surety and its bail producer from any further liability or responsibility in relation to the collateral. Returning collateral from receipt numbers) Depositor Phone Number (407) 436-1020 Case Number 25CF3044 Defendant Name JOSE ANTONIO LOPEZ Bond Amount $ 18,000.00 Amount or Estimated Value Held By Bail Producer Bail Producer Bail Producer L L Surety Surety Surety $ $ $$ 408,200.00 % in the amount of $ Bail Producer Signature Print Name Jessica B COLLATERAL RECEIPT Except as otherwise provided by applicable law (if any) as stated in the Bail Bond Agreement ("Agreement"), you are depositing the collateral as security for the payment of any and all monies and sums due to Surety or its Bail Producer, including all liability, claims, demands, debts (including promissory notes), damages, judgments, losses, interest, premiums, expenses, services charges, expenditures, attorneys' fees and costs suffered, sustained, made or incurred by Surety or its Bail Producers on account of, arising out of or relating to the above bail bond and transactions contemplated thereby, your failure to comply with the terms and conditions of the Agreement and any and all debt or other obligations arising out of or evidenced by any agreement executed by you, Defendant or any other indemnitors) for the benefit of Surety or its Bail Producer, all of the terms of which are made a part of this receipt by this reference ("Liabilities"). The Bail Producer will make the collateral available for return to the person whose name appears as Depositor on the Collateral Receipt (or that person's heir, legal representative, or successor in interest) within 10 days, or as stated in the Agreement, after receiving written notice from the court that the Bond and the Surety have been exonerated, and must verify with the court that the obligation has been exonerated before returning the Bond. If the collateral you provided included a document that conveys title to a lien on real property and such document was recorded, the Bail Producer or Surety shall deliver a reconveyance of the property, executed in such a manner that it may also be recorded, to you or your heir, legal representative or successor in interest within 10 working days, or as stated in the Agreement, after the Bail Producer or Surety receives notice of the exoneration of the Bond in writing by the court. The Bail Producer or Surety shall deliver such reconveyance document to you by making the document available at its principal place of business or mailing it to you upon your request. The Bail Producer or Surety will not return any collateral to you until you provide the written receipt that identifies the Bond, describes the collateral, and shows your signature. For any complaints or inquiries, you may contact the 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), www.MyFloridaCFO.com/Division/Consumers. PREMIUM RECEIPT and STATEMENT OF CHARGES allegheny CASUALTY COMPANY PO Box 5600, Thousand Oaks, CA 91359 800.935.2245 info@aiasurety.com Date Received 9/25/25 Payer Name Payment • Cash Method • Check • Credit Card • Money Order Gladys Lopez Defendant JOSE ANTONIO LOPEZ Power Numbers) AS3K-TBK Receipt No.: AP- 1508720 PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE: Bail 2 GO Kissimmee (Osceola County) 120 Simpson Rd Ste A Kissimmee, FL 34744 (407) 483-7983 Credit Card Authorization Code Amount Received ($) $ 1,800.00 Payer Phone Number (407) 436-1020 Bond Amount ($) $ 18,000.00 Court CIRCUIT Appearance Date TBN Itemized Expense(s) (if and as permitted by applicable law) Expense(s) $ $ $ $ KU O Form# ACC.0304-1 (10/21) Payer Signature Print Name Gladys Lopez Case Number(s) 25CF3044 Appearance Time Collateral Received Collateral Receipt Number(s) TBN • Yes • No 0924252023 Expense Amount Bail Bond Premium $ $ 1,800.00 Total Expense(s) $ $ 1,800.00 Prior Payments) ($ Amount Received ($ $ Remaining Balance Producer/Representative Signature $ 1,800.00 $ 0.00 Producer/Representative Print Name Jessica B ) PREMIUM RECEIPT and STATEMENT OF CHARGES I understand that the premium owing or paid is fully earned upon the Defendant's release from custody, and the fact that the Defendant may have been improperly arrested, re-arrested, the case dismissed, or the bail reduced shall not obligate the return or forgiveness of any portion of the premium except as otherwise provided by applicable law (if any) as stated in the Bail Bond Agreement.

AGENTS Completed File Check List Folder Named Properly - (LAST, FIRST - 06/15/25 - NZ) All Files are named correctly in Folder, - (DOE, JOHN - PREMIUM ) Booking Sheet / Mugshot (Current or Previous) TLO's for all parties involved Clerk Search for "ALL" Relevant Counties State ID's for all signers In…

9/25/25, 3:02 PM idiCORE idiCORE Expanded Person Search Last Name: LOPEZ First Name: JOSE Exact First Name: No Date of Birth: 03/06/1978 City: kissimmee State: fl Reference ID: JOSE ANTONIO LOPEZ 1 of 3 results). JOSE ANTONIO LOPEZ show alias (10) SSN: XXX-XX- XXXX Issued in Massachusetts, 1979 DOB:…

Packet Completed By: JESSICA Indemnitor: Jose Lopez Ind Add. 4054 Sunny Day Way Ind Home # Relationship to Def.: IA PN Collateral Explained: Social Security: ACF#: 0924252023 City: Kissimmee _ State: FI Zip: 34744 Ind Cell # (407) 436-1020 Email: Dad _ How long known Def.: life Mortgagee Deed ($17.0…

9/6/25, 1:19 PM Back to search 4054 Sunny Day Way, Kissimmee, FL 34744 | Zillow 2 Zillow Save Share ••• More Off market 88 See all 25 photos Zestimate® $408,200 4054 Sunny Day Way, Kissimmee, FL 34744 Est. refi payment: $3,342/mo (S Refinance your loan 4 beds 2 baths 2,236 sqft al SingleFamily $408,…

Packet Completed By: Jessica/ xp Defendant:_ Def Add. Def Home # Condition(s) of Bond: Check in Schedule: Phone In Days : Walk In Days: JOSE ANTONIO LOPEZ 4054 sunny day way Mon Mon Social Security: _ City: Kissimmee _ State: Florida Def Cell # (407) 968-7323 Email: Come in every wed to check-in Con…

9/25/25, 6:07 PM Osceola County Corrections I Details Name: JOSE ANTONIO LOPEZ ID: 1508720 Name: AKA: DOB: Inmate ID: Booking: Category: 09/13/2000 1508720 | 25007799 ADULT JOSE ANTONIO LOPEZ Race: Sex: Eyes: Hair: Weight: Height: W M BRO BRO 195 5'11" Offense 834452 834453 834454 834455 834456 8344…

American Spirit Processing Payment Gateway 9/24/25, 8:17 PM Transaction Successful Transaction Receipt Void Refund Transaction Information Merchant: Axiom Surety Corp - (Orlando, FL) Transaction ID: 11180293318 Amount: $1,800.00 Date: 09/24/2025 8:16:46 PM EDT Transaction Type: Card Sale Entry Metho…

Packet Completed By: JESSICA Indemnitor: Jose Lopez Ind Add. 4054 Sunny Day Way Ind Home # Relationship to Def.: IA PN Collateral Explained: _ Social Security: City: _ Kissimmee _ State: Ind Cell # (407) 436-1020 Dad _ How long known Def.: Mortgagee Deed ($17.00) Signature & Mortgage Deed Collateral…

+ LOPEZ, JOSE ANTONIO JR (2000) LOPEZ, JOSE ANTONIO JR (2000) DEFENDANT DEFENDANT 2025 CF 003044 2025 CF 002896 OPEN OPEN

Credit Card Authorization form 1,. JOSE ANTONIO LOPEZ , give permission to Axiom Surety Corp dba Bail 2 GO to charge Indemnitor my card for the following transaction(s). My card details will be stored under my Bail 2 GO profile and will only be used for approved transaction(s) and incurred expenses.…

9/24/25, 8:09 PM Osceola County Corrections I Details Name: JOSE ANTONIO LOPEZ ID: 1508720 Name: AKA: DOB: Inmate ID: Booking: Category: 09/13/2000 1508720 | 25007799 ADULT OSCEOTA COUNTY Number: 1508720 JOSE ANTONIO LOPEZ Race: Sex: Eyes: Hair: Weight: Height: W M BRO BRO 195 5'11" Offense 834452 8…

9/24/25, 8:09 PM Osceola County Corrections I Details Name: JOSE ANTONIO LOPEZ ID: 1508720 Name: AKA: DOB: Inmate ID: Booking: Category: 09/13/2000 1508720 | 25007799 ADULT OSCEOTA COUNTY Number: 1508720 JOSE ANTONIO LOPEZ Race: Sex: Eyes: Hair: Weight: Height: W M BRO BRO 195 5'11" Offense 834452 8…

9/24/25, 8:09 PM Osceola County Corrections I Details Name: JOSE ANTONIO LOPEZ ID: 1508720 Name: AKA: DOB: Inmate ID: Booking: Category: 09/13/2000 1508720 | 25007799 ADULT OSCEOTA COUNTY Number: 1508720 JOSE ANTONIO LOPEZ Race: Sex: Eyes: Hair: Weight: Height: W M BRO BRO 195 5'11" Offense 834452 8…

9/24/25, 8:09 PM Osceola County Corrections I Details Name: JOSE ANTONIO LOPEZ ID: 1508720 Name: AKA: DOB: Inmate ID: Booking: Category: 09/13/2000 1508720 | 25007799 ADULT OSCEOTA COUNTY Number: 1508720 JOSE ANTONIO LOPEZ Race: Sex: Eyes: Hair: Weight: Height: W M BRO BRO 195 5'11" Offense 834452 8…

9/24/25, 8:09 PM Osceola County Corrections I Details Name: JOSE ANTONIO LOPEZ ID: 1508720 Name: AKA: DOB: Inmate ID: Booking: Category: 09/13/2000 1508720 | 25007799 ADULT OSCEOTA COUNTY Number: 1508720 JOSE ANTONIO LOPEZ Race: Sex: Eyes: Hair: Weight: Height: W M BRO BRO 195 5'11" Offense 834452 8…