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Packet Completed by: 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 Surety ACF#: Zip…

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…

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 licensed Florida bail bond agency serving Central Florida families 24 hours a day, 7 days a week. We are bonded through Allegheny Casualty Company and regulated by the Florida Department of Financial Services. Our team has helped thousands of families secure the release of their loved ones quickly, legally, and without surprises. When you sign with Bail 2 GO you are in the hands of professionals who know exactly how to get your loved one home. A WHAT YOU ARE AGREEING TO • You are personally guaranteeing that KEITH LAMAR CLARK appears at all scheduled court dates • If the defendant fails to appear you may be held liable for the full bond amount plus all recovery and court costs • You are signing a Contingent Promissory Note in favor of Allegheny Casualty Company • Your electronic signature carries the same legal weight as a handwritten signature under Florida law / HAVE THESE READY BEFORE YOU BEGIN • Government-issued photo ID — driver's license, passport, or state ID • Device with a working camera for live identity verification photo • Current home address, employer information, and Social Security Number • Contact info for up to 6 personal references — name, relationship, city, phone • 10 to 15 minutes of uninterrupted time — most applicants complete this in one sitting E NEED TO STEP AWAY? Click "Save and Continue Later" at any time - we will email you a secure link to return. Call us at (833) 224- 5246 if you need help. A FLORIDA FRAUD WARNING I A PROTECT YOURSELF FROM PAYMENT FRAUD Submitting false or misleading information on this application is a felony under Florida law. Bail 2 GO will never request payment via wire transfer, gift card, or cryptocurrency without a secure confirmation code from our office. All standard payments go through Square. Call (833) 224-5246 if anything seems unusual. 2 Ready? Let's get KEITH LAMAR CLARK home. (833) 224-5246 1 Kissimmee | Orlando I Sanford Review Your Bond Details & Financial Obligations Your Bail 2 GO advisor has prepared this summary based on your approved bond. Review every detail carefully. If anything looks incorrect do not proceed — call your advisor at (833) 224-5246 immediately before continuing. Ô YOUR APPROVED BOND SUMMARY BOND REFERENCE Defendant County Booking Number Case Number 1 Case Number 2 Total Bond Liability Total Premium Due KEITH LAMAR CLARK 26025822 1500 200 A If anything above is incorrect stop and call (833) 224-5246 before proceeding. A CONTINGENT PROMISSORY NOTE - PLAIN LANGUAGE SUMMARY Below you will find the full Contingent Promissory Note. Before you read the legal language here is what it means in plain terms: • This note secures the full bond amount on behalf of Allegheny Casualty Company - it is not a present loan or debt • If KEITH LAMAR CLARK appears at all required court dates and the bond is exonerated - this note becomes null and void • If the defendant fails to appear — you may owe the full bond amount plus court costs, attorney fees, recovery expenses, and investigative costs • Any unpaid balance after a forfeiture accrues interest at 18% per year from the date of demand until paid in full The full legal text of the Promissory Note is displayed below. Read it carefully before checking the box and proceeding to the application. Contingent Promissory Note Accepted This Contingent Promissory Note (Note) is executed by the undersigned indemnitor ("Maker") in favor of Allegheny Casualty Company ("Surety") in connection with the bail bond issued for the defendant listed above. The Maker understands that this Note secures the full amount of the bond listed above and any costs or expenses incurred by the Surety as a result of the Defendant's failure to comply with court requirements. This Note is provided as security for any loss, forfeiture, costs, or expenses incurred by the Surety as a result of the Defendant's failure to comply with the conditions of the bail bond or failure to appear in court. If the bond is forfeited or the Defendant fails to appear as required, the Maker agrees to pay to the order of Allegheny Casualty Company the full amount owed as a result of the forfeiture, including but not limited to the bond amount, court costs, attorney's fees, recovery expenses, investigative costs, and any other reasonable costs incurred by the Surety in enforcing this obligation. Any unpaid balance shall accrue interest at the rate of eighteen percent (18%) per year from the date of demand until paid in full. This Note does not represent a present loan or debt and is executed solely to secure future obligations that may arise if 4 the Defendant fails to comply with court requirements. Vlf the Defendant appears at all required court proceedings and the bond is discharged or exonerated by the court, this Note shall become null and void. Otherwise, this Note shall have been satisfied. By checking the box below and signing, you confirm that you have reviewed all bond details above, accept your responsibilities as the indemnitor, and agree to the terms of this Contingent Promissory Note. This constitutes a legally binding financial obligation to Bail 2 GO and Allegheny Casualty Company for the duration of this bond. A IMPORTANT — If any of the information above is incorrect, do not proceed. Stop immediately and contact your Bail 2 GO agent before continuing. Indemnitor Information Name Kymeia Clark Date of Birth Friday, June 1, 2001 Place of Birth Palatka fl Gender Female Social Security Number U.S. Citizen? (Yes / No) 770322972 YES Government Photo ID Verification NOTE: • Front required • Back required if applicable • File types: JPG, PNG, PDF • Min: 1 file | Max: 2 files Uploaded identification is used solely for identity verification and underwriting purposes and is securely stored. 5 U.S. Drivers License/State Identification Card/U.S. Passport/Permanent Resident Card (Green Card)/Other government- issued photo ID GEORGIA DRIVER'S LICENSE DL DRIVER'S LICENSE -OL NO. 072781303 1 008 06/01/2001 • CLAsS C •Ex* 06/01/2033 2 KYMEIA LAKASIA •CLARK 28 CEDAR POINTE RO AWORTH, GA 30101-9019 BARTOW 12 REST A NONE 11/13/2025 18 EYES 15 SEX 18 NGT 5-04" BRO 117lb - De S 00 618451337240020/ ID Type Submitted Driver's License Residence Information Time at Current Residence Residential Address: Residence Type 2 months 19 waverly In Palm coast, Florida, 32164 House Housing Status Rent N/A Landlord Name Contact & Employment Phone Number Carrier Phone Type (386) 302-8759 Cricket Length of Time with Number iphone 4 years 6 Email Address Employment Status: Employer Position Length Work Phone Legal & Finicial Background Ever filed bankruptcy? CLARKKYMEIA@YAHOO.COM Employed Amazon Warehouse associate 1 month (386) 302-8759 No Any judgments or liens? Convicted felon? No No On probation or parole? No Vehicle Information Own a vehicle? No Defendant Relationship Relationship to Defendant Length of Relationship Defendant Cell Phone Emergency Contact & Family Name Phone Address Marital Status Daughter 25 years (386) 302-3265 Kayce Clark (386) 864-3697 19 waverly In Palm coast fl Single Children? No Attorney & Source 7 Do you have an attorney? No How did you hear about us? Google Personal References Reference 1 Reference 1 Relationship Reference 1 City/State Reference 1 Phone Number Reference 2 Reference 2 Relationship Reference 2 City/State Reference 2 Phone Number Reference 3 Reference 3 Relationship Reference 3 City/State Reference 3 Phone Number Reference 4 Reference 4 Relationship Reference 4 City/State Reference 4 Phone Number Kierra Clark Daughter Florida (386) 864-3695 Kayce Clark Daughter FL (386) 864-3697 Jameshia Clark Wife FL (386) 302-7328 Janisha Jones Niece FI (386) 283-3724 Full Bond Agreement Acceptance & Identity Verification A FRAUD WARNING - FLORIDA STATUTE Any person who knowingly and with the intent to injure, defraud, or deceive any insurer submits an application, statement, or claim containing false, incomplete, or misleading information commits insurance fraud. Such conduct constitutes a felony of the third degree under Florida law and may result in criminal prosecution, fines, and imprisonment. 8 Full Bond Agreement Accepted Bail Bond Surety Agreement - Terms & Conditions You, the undersigned (referred to herein as "Indemnitor", "Defendant", or collectively as "you" or "your", as applicable), agree to be bound by the following terms and conditions. 1. The premium for the bond is fully earned upon the release of the Defendant from custody. The premium is not refundable except as provided by applicable law. The fact that the Defendant may have been improperly arrested, the bail reduced, or the criminal case dismissed does not obligate the Surety to return the premium or any portion of it. 2. The Defendant agrees to appear in court as required in connection with this bond and at the dates and times stated in the bond and/or ordered by the court. The Indemnitor agrees to ensure that the Defendant appears in court as required. 3. The Surety shall have control and jurisdiction over the Defendant during the term for which the bond is in effect and shall have the right to apprehend, arrest, and surrender the Defendant to the proper officials at any time as permitted by law and this agreement. 4. Unless otherwise provided by applicable law, the following events shall constitute a breach of the obligations to the Surety and the Surety shall have the right to immediately apprehend, arrest, and surrender the Detendant to custody, and no person shall have any right to a refund of the premium: a. If the Defendant departs the jurisdiction of the court without written consent of the court and the Surety or its b. If the Defendant moves from his or her address without notifying the Surety or its agent in writing prior to such move. c. If the Defendant commits any act which constitutes reasonable evidence of an intention to cause forfeiture of the bond or fails to appear in court as required. d. If the Defendant is arrested and incarcerated for any offense other than a minor traffic violation. e. If the Defendant or Indemnitor makes any material false statement in the bail bond application or indemnitor application. f. If the bail for the Defendant is increased. . If the Indemnitor requests surrender of the Defendant Surety, including depreciation or impairment of any collateral pledged as security. 5. In the event that apprehension and surrender of the Defendant is required for any reason, including failure to appear in court, the Defendant understands and acknowledges that such apprehension may involve risk. The Defendant agrees to indemnify and hold the Surety harmless rom injuries, losses, claims, lawsuits, damages, liability demands, fees, and expenses arising from such apprehensior or surrender. 9 6. The Indemnitor agrees to indemnify and hold the Surety harmless from and against any and all claims, damages, losses, liabilities, demands, actions, judgments, fines, penalties, costs, and expenses (including attorneys' fees) relating to or arising out of the issuance of the bond. This includes but is not limited to: a. The principal amount of any forfeiture or judgment on the bond, plus related court costs, interest, and legal fees b. Any fugitive recovery fee if the bond is forfeited, which is typically ten to twenty percent of the amount of the bond plus expenses. c. Costs incurred to extradite or apprehend the Defendant. d. Any attorneys' fees and costs incurred to enforce this agreement. The Surety may demand payment of these liabilities before or after payment has been made by the Surety. 7. Any collateral pledged or deposited with the Surety as security for this agreement shall be held to secure payment of any liabilities sustained or incurred by the Surety. The Surety may apply, sell, or otherwise dispose of collateral to satisfy such obligations. 8. The Surety shall not be liable for any depreciation of collateral or for any interest thereon. If the value of collateral decreases, the Surety may require additional collateral to maintain adequate security. 9. If a Confession of Judgment ("COJ") is taken as security for the bond, the Surety may file or record such COJ at any time and it shall constitute a lien against the Indemnitor's property. 10. The Surety may foreclose against collateral and/or exercise any other legal remedy available under this agreement without waiving any other rights. 11. Subject to applicable law, the Surety shall return collateral when all of the following conditions are satisfied: a. The Surety receives written proof from the court that the bond has been discharged. b. There are no outstanding liabilities relating to the bond. c. No obligations remain which may expose the Surety to future liability. 12. The Surety may transfer or assign its rights under this agreement to another party without notice to the Indemnitor. 13. The Surety and bail producer do not recommend or suggest any attorney to represent the Defendant. 14. This agreement may not be modified or terminated orally. Any modification must be in writing and signed by both parties. 15. To the maximum extent permitted by law, you authorize 10 the Surety to obtain any information or records concerning you trom any public or private agency including credit reports, criminal records, driving records, employment records, school records, medical records, tax records, and telephone records. 16. You irrevocably grant the Surety and its agents the right to enter your residence or property without notice for the purpose of locating, arresting, or returning the Defendant to custody as permitted by law. 17. The Defendant acknowledges that the Surety may use location tracking technologies to monitor the Defendant during the period the bond is in effect and during any applicable remission period. The Defendant acknowledges that this monitoring may involve the collection and use of location data and that the Defendant may not opt out of such monitoring while the bond remains active. 18. If the Defendant leaves the state in which the bond was issued, the Defendant waives any right to oppose extradition proceedings. 19. If any provision of this agreement is determined to be invalid or unenforceable, the remaining provisions shall remain in full force and effect. 20. This agreement and all documents executed in connection with it constitute the entire agreement between the parties. SUPPLEMENTAL TERMS AND CONDITIONS 1. The Surety, as bail, shall have control and jurisdiction over the Defendant during the term for which the bond is executed and shall have the right to apprehend, arrest, and surrender the Defendant to the proper officials as provided by law. 2. In the event the Defendant is surrendered before the time set for court appearance and for reasons other than those constituting a breach of this agreement, the premium may be refunded to the person shown as payer on the premium receipt as permitted by law. 3. If the Defendant fails to appear in court, departs the jurisdiction without consent, moves without notifying the Surety, commits another offense, or makes any false statement in connection with the bond, such actions constitute a breach of the Defendant's obligations. 4. For complaints or inquiries regarding bail bonds, contact the Florida Department of Financial Services, Division of Consumer Services, Bail Bond Section, 200 East Gaines Street, Tallahassee, Florida 32399, phone (850) 413-5660. 5. The person whose name appears as payer on the premium receipt shall be entitled to a refund only if the Surety has no liability under the bond because the Defendant was not released from custody or the bond was written to allow the Defendant to serve a sentence in another jurisdiction. 6. The Indemnitor agrees to indemnify and hold harmless the 11 Surety and its agents for all losses not otherwise prohibited by 7. The Indemnitor acknowledges receipt of copies of this agreement and related documents concerning the bond and recommitment of the Defendant. 8. Costs which may be recovered by the Surety include expenses necessary to apprehend the Defendant, attorney fees, court costs, transportation costs, and a surrender fee allowed by law. 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. 10. The Surety may deduct from collateral any fees, expenses, or charges authorized by law, including Florida Administrative Code 69B-221.105. 11. Except as expressly provided in this supplement, all terms and conditions of the agreement remain in full force and As principal (defendant) 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. 12 For further inquiry / complaint, contact Department of Financial Services Bail Bond Section 200 East Gaines Street Tallahassee, FL 32399-0320 Phone: (850) 413-5660 Background Check Authorization & Accuracy Certification Terms and Conditions Accepted Communication Authorization Terms and Conditions Accepted Final Certification & E-Signature Consent Terms and Conditions Accepted Indemnitor Printed Name Kymeia Clark Photo Verification (Hold ID Next to Face) Please take a clear photo of yourself to confirm your identity for this bail bond application Indemnitor Signature NBIS Date & Time: Saturday, August 1, 2026 04:09 13

GEORGIA DRIVER'S LICENSE Governor: B:lh Commissioner DL DRIVER'S LICENSE 4d DL NO. 072781303 3 DOB 06/01/2001 9 CLASS C 4b EXP 06/01/2033 2 KYMEIA LAKASIA 1 CLARK 8 28 CEDAR POINTE RD ACWORTH, GA 30101-9019 BARTOW 12 REST A 9a END NONE 4a ISS 11/13/2025 15 SEX 18 EYES 16 HGT 5'-04" 17 WGT BRO 117 lb…

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,…

Orange County Incarcerations CLARK, KEITH LAMAR Booking Number: Race: Gender: Age: Cell: Date Booked: Number of Holds: Notes: 26025822 BLACK MALE 43 Last Known Location: PALM COAST BRCMBFNA 08/01/2026 NONE Case Sequence: Case Status: Bond Amount: Police Case Number: Arresting Agency: Charge/Court Ca…

Saturday, August 1, 2026 Bail 2 GO LEAD CAPTURE - (Always required - the person calling in) KISSIMMEE - ORLANDO - SANFORD Approval Status NOT_STARTED IGNITE — Underwriting Review You have been assigned this bond intake for underwriting review. All intake data collected by the advisor is pre- filled …

Notification Settings • KEITH LAMAR CLARK ( Defendant, Indemnitor) Turn Notifications On? Yes No Types Appearance Date Standard Appearance Track Checkin Due • Standard Check-In Payment Due : N/A