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Packet Completed By: RRAMOS Indemnitor: WANDA GRIFFIN Ind Add. 1113 SANTA ANITA ST Ind Home # (407) 300-0689 Social Security: _ 264-04-9103ACF#: 080620241910 City:_ORLANDO_ State: _ FL 32808 Ind Cell # (407) 300-0689 Zip: _ Email: WANDAGFRMDAOFC Relationship to Def.: MOTHER — How long known Def.: LIFE IA PN Mortgagee Deed ($17.00) • SIGNATURE BOND ONLY Vessel Title ($75.00 fee) Collateral Explained: _ Collateral in Amount of $ 0.00 • Cash • Check co | MO Collateral held by Bondsman Surety Condition(s) of Bond: MUST CHECK IN EVERY TUESDAY VIA BVMA UNTIL BONDS ARE DISCHARGED CHAMPAYNE SMITH Defendant Name: dob: 04/10/87 Booking #. F 08/06/24 doa: sex: Execution Date: 8/6/24 Power No: AIA TRANSFER Bond Amount: _ PETIT THEFT 2 PRIOR CONVICTIONS Charge: $ 1,000.00 Premium: Case No: TBN Court Date: _ AIA TRANSFER Power No: Charge: FTA (PETIT THEFT) $ 100.00 Premium: Case No: AIA TRANSFER TBN Court Date: Power No: AIA TRANSFER Charge: LARCENY / GRAND THEFT $ 100.00 Premium: Case No: TBN Court Date: Detainer: _ Court: County: Time: Bond Amount: Detainer: _ Court: County: - Time: Bond Amount: Detainer: _ Court: County: _ Time: Continue to Next Paae 2024-22863 race: $ 10,000.00 COUNTY POLK TBN $ 1,000.00 COUNTY OSCEOLA TBN $ 500.00 CO / CIR OSCEOLA 23MM212 Agent: City: RAUL RAMOS ORLANDO Agent Lic No: State: W311154 FL Total Premium: Misc Charges: $ 1,200.00 $ 100.00 Money Received on Account: Balance $ 400.00 $3) 2024-2286380620241910 Total Liability: Total Charges: $ 900.00 Due Date: Received From: $ 11,500.00 $ 1,300.00 8/7/24 WANDA GRIFFIN CO BAIL BOND APPLICATION - INDEMNITOR COMPANY ALLEGHENY CASUALTY COMPANY P.O. Box 9810, CALABASAS, CA 91372-9810 TELEPHONE (800) 935-2245 BAIL 2 GO P.O. Box 592643, ORLANDO, FL 32859-2643 TELEPHONE (407) 254-5554 1. Name _ First WANDA DENESE GRIFFIN Middle Last 1113 SANTA ANITA ST 2. Residence Address. 3. How Long at Current Address 10YR Rent Free 4. Is Mortgage/Lease in your name? Yes. 5. Cell Phone # 407-300-0689 _ No. Cell Carrier 6. Employer RETIRED Length Any ownership greater than 20% in any Corporation, LLC, or S-Corp 7. Social Security No. 264049103 ID# G615-904-53-526-0 8. Have you ever filed Bankruptcy. My friends/family know me as NO ORLANDO 9. Gender Place of Birth 10. Have many years have you lived in FL? 11. Vehicle Year Vehicle Color 12. Relationship to Defendant Defendants Home Address ORLANDO City - _ State. FL _ Zip 32808 Lease _ Own X Landlord/Mortgagor Name When does Lease Expire _ Email WANDAGFRMDAOF@GMAI iPhone or Android ANDROID How Long with Cell No. Position Work # NO _ Any specialized license to work _ Wt. Ht 57 Race _B_Eye Color BRN Hair NO Do you have any judgements or liens against you currently _ If so, where NO NO Date of Birth 01/26/1953 US Citizen Marital Status SEP How Long LIFE NO NO Are you a convicted felon? Are you on any type of Probation or Parole ? Vehicle Make MOTHER Tag No. Vehicle Miles How long have you known Defendant SAME Defendants Cell Phone Number Amount Owed LIFE 407-497-4159 13. Emergency Contact Name Address Phone No. 13. Children Yes No Amount of children Ages Do kids reside with you 14. Attorney Phone No. PREVIOUS CLIENT May we reach out on the defendants behalf 15. How did you hear about us? Personal References First & Last Name ANDREW GRIFFIN 1._ 2. 3. 4. 5._ 6. JONITA ROBINSON HEAVEN THOMAS MYA SMITH Relationship HUSBAND NEICE GRAND DA GRAND DA City / State ORLANDO ORLANDO ORLANDO ORLANDO Phone 407-485-6457 407-230-6006 352-936-9118 321-795-0642 I hereby represent and warrant that the foregoing information is true, complete and correct and is made for the purpose of inducing International Fidelity Insurance Company/Allegheny Casualty Company to issue, or cause to be issued, bail bond(s) for 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 StandShi Print WANDA GRIFFIN ID# SSN DOB allegheny CASUALTY COMPANY PO Box 5600, Thousand Oaks, CA 91359 800.935.2245 info@aiasurety.com BAIL BOND AGREEMENT ("Agreement") PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE: %DIOT * 2 Orlando (Orange County) 16 RX- RKQ< RXQJ 3N2\ 2 LOQGRI) / MOI THIS IS A DOUBLE SIDED DOCUMENT READ ALL SIDES CAREFULLY 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 8/6/24 CHAMPAYNE SMITH Indemnitor Name(s) WANDA GRIFFIN Total Bond Amount $ $ 11,500.00 Total Premium $ $ 1,200.00 Power Number(s) AIA TRANSFER AIA TRANSFER ("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 8/6/24 Print Name CHAMPAYNE SMITH indemnior signature ten Destin Print Name WANDA GRIFFIN Indemnitor Signature Indemnitor Signature Print Name Print Name Indemnitor Signature Print Name Indemnitor Signature Print Name Si no puede leer ni entender Inglés, favor de marcar este cuadro. Check box and complete the (If you cannot read or understand English, please check this box.) 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 Orlando (Orange County) 3800 South John Young Pkwy Orlando, FL 32839 (407) 254-5554 Defendant Name CHAMPAYNE SMITH Power Numbers) Case Number AIA TRANSFER 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 bonds), 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 WANDA GRIFFIN Signed original to agent's bond file; Copy to defendant and each indemnitor Date 8/6/24 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: CHAMPAYNE SMITH ("Defendant"). On demands after date, for value received, I/We promise to pay to the order of Allegheny Casualty Company the sum of $ $ 11,500.00 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 numbers) AIA TRANSFER , POLK COUNTY, FLORIDA P/A numbers) AIA TRANSFER Haul Stiffer AIA TRANSFER Signature Signature WANDA GRIFFIN Maker Name Form# ACC.FL.0036 (10/21) 8/6/24 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). L Date Received 8/6/24 Depositor Name(s) WANDA GRIFFIN Depositor Address 1113 SANTA ANITA ST Power Number(s) Case Number AIA TRANSFERAIA TRANSFER Items) Received - describe below, specify condition Promissory Note, Signature Bail Bond Agreement Collateral funds - in form of SIGNATURE BOND ONLY If applicable, I acknowledge a Credit Card fee of positor FLORIDA USE ONLY Form# ACC.FL.0304-2 (01/23) Signature Print Name Santa trper WANDA GRIFFIN Receipt No.: ACFL- 080620241910 PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED Bail 2 GO Orlando (Orange County) 3800 South John Young Pkwy Orlando, FL 32839 (407) 254-5554 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) 300-0689 Defendant Name CHAMPAYNE SMITH Bond Amount $ 11,500.00 Amount or Estimated Value $ $ $$ 0.00 % in the amount of $ Signature Bail Producer Print Name L RAUL RAMOS Held By Bail Producer Bail Producer Bail Producer L L Surety Surety Surety 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 Receipt No.: AP- 2024-22863 PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE Bail 2 GO Orlando (Orange County) 3800 South John Young Pkwy Orlando, FL 32839 (407) 254-5554 Date Received 8/6/24 Payer Name Payment Method • Cash • Check • Credit Card • Money Order Credit Card Authorization Code Amount Received ($) $ 900.00 Payer Phone Number WANDA GRIFFIN (407) 300-0689 Defendant Bond Amount ($) CHAMPAYNE SMITH $ 11,500.00 Power Numbers) Case Number(s) AIA TRANSFER Court COUNTY COUNTY AIA TRANSFER Appearance Date TBN TBN Appearance Time TBN AIA TRANSFER Collateral Received Collateral Receipt Numbers) • Yes • No 080620241910 Itemized Expense(s) (if and as permitted by applicable law) Expense(s) $ Expense Amount $ 100.00 Bail Bond Premium Total Expense(s) $ $ 1,200.00 $ $ 1,300.00 $ Prior Payments) ($ $ Amount Received ($ $ Remaining Balance $ $900.00 $400.00 *08185 * Paid Form# ACC.0304-1 (10/21) Print Name WANDA GRIFFIN Received By Producer/Representative Signature Producer/Representative Print Name RAUL RAMOS ) ) PREMIUM RECEIPT and STATEMENT OF CHARGES I understand that the premium owing or paid is fully earned upon the Defendant's release from custody, and the fact that the Defendant may have been improperly arrested, re-arrested, the case dismissed, or the bail reduced shall not obligate the return or forgiveness of any portion of the premium except as otherwise provided by applicable law (if any) as stated in the Bail Bond allegheny CASUALTY COMPANY PO Box 5600, Thousand Oaks, CA 91359 800.935.2245 info@aiasurety.com FOR FURTHER ACTION ON THIS BOND NOTIFY: Bail 2 GO P.O. Box 592643 Orlando, FL 32859 Email: courtdates@bail2go.com Transfer agent dob: 04/10/87 doa: 08/06/24 seX: F race: B General Surety Appearance Bond Power Number Arrest Number IN THE COUNTY AIA TRANSFER 2024-22863 STATE OF FLORIDA VS: COURT CHAMPAYNE SMITH POLK COUNTY KNOW ALL MEN BY THESE PRESENTS: That we, the above captioned defendant as Principal, and Allegheny Casualty Company, a New Jersey corporation, as Surety are held and firmly bound unto the State of Florida and its successors, to the penal sum of ($) $ 10,000.00 for the payment whereof well and truly to be made we bind ourselves, our heirs, representatives, successors, and assigns firmly by these presents. The condition of this obligation is such that if said Principal shall appear on TBN at TBN the next Regular or Special term of the above court and shall submit to the said Court to answer a charge of: PETIT THEFT 2 PRIOR CONVICTIONS for case number and shall submit to orders and process of said court and not depart the same without leave, then this obligation to be void, else to remain in full force and virtue. Signed, sealed and delivered this 8/6/24 TAKEN BEFORE ME AND APPROVED BY ME: (L.S.) _, Clerk / Sheriff (Principal) Allegheny Casualty Company By By Agent / License Number Agent Name (Attorney in fact) (SURETY) W311154 RAUL RAMOS ANTO This bond not valid for deferred sentence, fines, pre-sentence investigation, pre-trial intervention programs or appeals STATEMENT OF BONDSMAN 1, the undersigned, am a duly licensed bail bond agent pursuant to Chapter 648, F.S., and have registered for the current year with the office of the Sheriff and Clerk of Court of the aforementioned county, and have filed a certified copy of my appointment by Power of Attorney for the Surety with the office of the Sheriff and Clerk of the Court of the aforementioned County. That said Principal of 1113 SANTA ANITA ST (Address) has (given or promised to give) the sum of ($) $ 1,000.00 as consideration for Bail Bond Number AIA TRANSFER filed with the Clerk of the above captioned court located in said county together with the (promise or receipt) of security belonging to WANDA GRIFFIN (Indemnitor(s)) as follows: (provide detailed description and source of security) (if none, so state). That a duly signed receipt has been given to the said Principal for the consideration given and/or that the said indemnitor has (also been) given a receipt for the security described above. (Bondsman) RAUL RAMOS (Agency) Bail 2 GO Orlando (Orange County) allegheny CASUALTY COMPANY PO Box 5600, Thousand Oaks, CA 91359 800.935.2245 info@aiasurety.com FOR FURTHER ACTION ON THIS BOND NOTIFY: Bail 2 GO P.O. Box 592643 Orlando, FL 32859 Email: courtdates@bail2go.com Transfer agent dob: 04/10/87 doa: 08/06/24 sex: F race: General Surety Appearance Bond Power Number Arrest Number IN THE_COUNTY AIA TRANSFER 2024-22863 STATE OF FLORIDA VS: COURT CHAMPAYNE SMITH OSCEOLA COUNTY KNOW ALL MEN BY THESE PRESENTS: That we, the above captioned defendant as Principal, and Allegheny Casualty Company, a New Jersey corporation, as Surety are held and firmly bound unto the State of Florida and its successors, to the penal sum of ($) $ 1,000.00 for the payment whereof well and truly to be made we bind ourselves, our heirs, representatives, successors, and assigns firmly by these presents. The condition of this obligation is such that if said Principal shall appear on TBN at TBN the next Regular or Special term of the above court and shall submit to the said Court to answer a charge of: FTA (PETIT THEFT) for case number AlA TRANSFER and shall submit to orders and process of said court and not depart the same without leave, then this obligation to be void, else to remain in full force and virtue. Signed, sealed and delivered this 8/6/24 TAKEN BEFORE ME AND APPROVED BY ME: _, Clerk / Sheriff (Principal) Allegheny Casualty Company (L.S.) ...., By By Agent / License Number Agent Name (Attorney in fact) (SURETY) W311154 RAUL RAMOS ANTO This bond not valid for deferred sentence, fines, pre-sentence investigation, pre-trial intervention programs or appeals STATEMENT OF BONDSMAN 1, the undersigned, am a duly licensed bail bond agent pursuant to Chapter 648, F.S., and have registered for the current year with the office of the Sheriff and Clerk of Court of the aforementioned county, and have filed a certified copy of my appointment by Power of Attorney for the Surety with the office of the Sheriff and Clerk of the Court of the aforementioned County. That said Principal of 1113 SANTA ANITA ST (Address) has (given or promised to give) the sum of ($) $ 100.00 as consideration for Bail Bond Number AIA TRANSFER filed with the Clerk of the above captioned court located in said county together with the (promise or receipt) of security belonging to WANDA GRIFFIN (Indemnitor(s)) as follows: (provide detailed description and source of security) (if none, so state). That a duly signed receipt has been given to the said Principal for the consideration given and/or that the said indemnitor has (also been) given a receipt for the security described above. (Bondsman) RAUL RAMOS (Agency) Bail 2 GO Orlando (Orange County) allegheny CASUALTY COMPANY PO Box 5600, Thousand Oaks, CA 91359 800.935.2245 info@aiasurety.com FOR FURTHER ACTION ON THIS BOND NOTIFY: Bail 2 GO P.O. Box 592643 Orlando, FL 32859 Email: courtdates@bail2go.com Transfer agent dob: 04/10/87 doa: 08/06/24 sex: F race: B General Surety Appearance Bond Power Number Arrest Number IN THE •CO / CIR AIA TRANSFER 2024-22863 STATE OF FLORIDA VS: COURT CHAMPAYNE SMITH OSCEOLA COUNTY KNOW ALL MEN BY THESE PRESENTS: That we, the above captioned defendant as Principal, and Allegheny Casualty Company, a New Jersey corporation, as Surety are held and firmly bound unto the State of Florida and its successors, to the penal sum of ($) $ 500.00 for the payment whereof well and truly to be made we bind ourselves, our heirs, representatives, successors, and assigns firmly by these presents. The condition of this obligation is such that if said Principal shall appear on TBN at 23MM212 the next Regular or Special term of the above court and shall submit to the said Court to answer a charge of: LARCENY / GRAND THEFT for case number and shall submit to orders and process of said court and not depart the same without leave, then this obligation to be void, else to remain in full force and virtue. Signed, sealed and delivered this 8/6/24 TAKEN BEFORE ME AND APPROVED BY ME: _, Clerk / Sheriff (Principal) Allegheny Casualty Company (L.S.) ......, By By Agent / License Number Agent Name (Attorney in fact) (SURETY) W311154 RAUL RAMOS This bond not valid for deferred sentence, fines, pre-sentence investigation, pre-trial intervention programs or appeals STATEMENT OF BONDSMAN 1, the undersigned, am a duly licensed bail bond agent pursuant to Chapter 648, F.S., and have registered for the current year with the office of the Sheriff and Clerk of Court of the aforementioned county, and have filed a certified copy of my appointment by Power of Attorney for the Surety with the office of the Sheriff and Clerk of the Court of the aforementioned County. That said Principal of 1113 SANTA ANITA ST (Address) has (given or promised to give) the sum of ($) $ 100.00 as consideration for Bail Bond Number AIA TRANSFER filed with the Clerk of the above captioned court located in said county together with the (promise or receipt) of security belonging to WANDA GRIFFIN (Indemnitor(s)) as follows: (provide detailed description and source of security) (if none, so state). That a duly signed receipt has been given to the said Principal for the consideration given and/or that the said indemnitor has (also been) given a receipt for the security described above. (Bondsman) RAUL RAMOS (Agency) Bail 2 GO Orlando (Orange County)

File	Classified as	Size	Modified	OCR	Links
2022-CF-009837-A-O-87186789-Electronic Copy to Bondsman.pdf 8/16/2024 10:14 AM FILED IN OFFICE TIFFANY M RUSSELL CLERK CIRCUIT COURT ORANGE CO FL IN THE CIRCUIT AND COUNTY COURT OF THE NINTH JUDICIAL CIRCUIT IN AND FOR ORANGE COUNTY, FLORIDA Court Case Number: 2022-CF-009837-A-O STATE OF FLORIDA, CHAMPAYNE DENISE SMITH DOB: 04/10/1987 Charge Description: GRA… [show full stored text]	Unclassified	1.2 MB	2024-09-18 15:11:27 uploaded 21d after created	no	Dropbox · History
2022-CF-009837-A-O-87417715-Court Minutes.pdf In the Circuit Court of the Ninth Judicial Circuit, in and for Orange County, Florida Division: Div 20 Case No: 2022-CF-009837-A-O Courtroom: 12-A State of Florida, Plaintiff, VS. CHAMPAYNE DENISE SMITH Defendant. Date of birth: 4/10/1987 Not Guilty/Deny entered as to -_. 1 GRAND THEFT THIRD DEGREE … [show full stored text]	Court/case doc	160.2 KB	2024-09-18 15:11:27 uploaded 14d after created	no	Dropbox · History
2022-CF-009837-A-O-88497582-Electronic Copy to Bondsman.pdf E In the Circuit Court of the Ninth Judicial Circuit, in and for Orange County, Florida Division: Div 20 Case No: 2022-CF-009837-A-O Courtroom: 12-A State of Florida, Plaintiff, vS. CHAMPAYNE DENISE SMITH Defendant. Date of birth: 4/10/1987 COURT ORDER & SETTING / RESET NOTICE This cause came on thi… [show full stored text]	Court/case doc	33.4 KB	2024-11-28 01:34:06	no	Dropbox · History
2024_08_26_10_30_49.pdf IN THE COUNTY COURT OF THE TENTH JUDICIAL CIRCUIT IN AND FOR POLK COUNTY, FLORIDA STATE OF FLORIDA, Plaintiff CASE NO.: 53-2024MM-006427-A000-BA VS. CHAMPAYNE DENISE SMITH 1113 SANTA ANITA ST ORLANDO FL 32808 JUDGE: ROBERT GRIFFIN Defendant NOTICE OF COURT DATE This is to notify you that your court … [show full stored text]	Unclassified	173.2 KB	2024-09-18 15:11:27 uploaded 23d after created	no	Dropbox · History
attachment1 3.PDF IN THE CIRCUIT COURT OF THE NINTH JUDICIAL CIRCUIT, IN AND FOR OSCEOLA COUNTY, FLORIDA Case Number: 2023 MM 000212 Division: COUNTY COURT STATE OF FLORIDA VS SMITH, CHAMPAYNE DENISE 4511 ARCH ST ORLANDO, FL 32808 DEFENDANT RESET NOTICE OF PUBLIC DEFENDER PRETRIAL The dUlL DEFEND PREr notife that the… [show full stored text]	Unclassified	53.6 KB	2024-10-13 08:43:01 uploaded 5d after created	no	Dropbox · History
attachment1.PDF IN THE COUNTY COURT OF THE NINTH JUDICIAL CIRCUIT IN AND FOR OSCEOLA COUNTY, FLORIDA Case No: 2023 MM 000212 Division: DIVISION 80-H STATE OF FLORIDA VS CHAMPAYNE DENISE SMITH 4511 ARCH ST ORLANDO. FL. 32808 NOTICE OF ARRAIGNMENT COURT DATES Defendant is hereby Ordered to appear for: Event ARRAIGNME… [show full stored text]	Court/case doc	204.4 KB	2024-09-18 15:11:27 uploaded 23d after created	no	Dropbox · History
Bond Discharge 12:13:2024.pdf 12/14/24, 9:33 AM Orange County Clerk - Court Records Search 2022-CF-009837-A-O : STATE OF FLORIDA - VS - SMITH, CHAMPAYNE DENISE Case Type: Location: Judge: Citation Number: Criminal Felony Div 20 Michael S Kraynick Criminal Felony Date Filed: UCN: Status: Appear By Date: 8/23/2022 482022CF00983700… [show full stored text]	Court/case doc	54.3 KB	2024-12-14 14:33:32	no	Dropbox · History
Griffin, Wanda D TLOxp.pdf TLOxp - Advanced 8/6/24, 8:20 PM Your Current Reference ID: NONE 1 Result Found for people named WANDA GRIFFIN born on 01/26/1953 in the United States. WANDA DENESE GRIFFIN, 71 Years Old (Orlando, FL) WANDA DENESE GRIFFIN Possible Relatives Cities (01/07/2011 to 06/04/2024) Andrew Griffin 1957 Age: … [show full stored text]	Unclassified	73.4 KB	2024-09-15 11:31:30 uploaded 39d after created	no	Dropbox · History
Hearing Date Received for Champayne Smith 01272025 Fri, 20 Dec 2024 221903 +0000 (UTC).PDF	Unreadable (Dropbox download failed) reason: download-error	299.9 KB	2024-12-30 04:08:36 uploaded 9d after created	yes	Dropbox · History
Hearing Date Received for Champayne Smith 09092024 Mon, 26 Aug 2024 161910 +0000 (UTC).PDF IN THE COUNTY COURT OF THE NINTH JUDICIAL CIRCUIT IN AND FOR OSCEOLA COUNTY, FLORIDA Case No: 2023 MM 000212 Division: DIVISION 80-H STATE OF FLORIDA VS CHAMPAYNE DENISE SMITH 4511 ARCH ST ORLANDO. FL. 32808 NOTICE OF ARRAIGNMENT COURT DATES Defendant is hereby Ordered to appear for: Event ARRAIGNME… [show full stored text]	Court/case doc	204.4 KB	2024-09-18 15:11:27 uploaded 23d after created	no	Dropbox · History
Hearing Date Received for Champayne Smith 10092024 Tue, 10 Sep 2024 170416 +0000 (UTC).PDF IN THE COUNTY COURT OF THE NINTH JUDICIAL CIRCUIT IN AND FOR OSCEOLA COUNTY, FLORIDA Case No: 2023 MM 000212 Date of Offense: 12/17/2022 STATE OF FLORIDA VS CHAMPAYNE DENISE SMITH 4511 ARCH ST ORLANDO, FL. 32808 Defendant PUBLIC DEFENDER 2 COURTHOUSE SQUARE SUITE 1600 KISSIMMEE, FL 34741 Attorney NO… [show full stored text]	Court/case doc	517.8 KB	2024-09-18 15:11:27 uploaded 8d after created	no	Dropbox · History
Hearing Date Received for Champayne Smith 12182024 Wed, 23 Oct 2024 221933 +0000 (UTC).PDF IN THE COUNTY COURT OF THE NINTH JUDICIAL CIRCUIT IN AND FOR OSCEOLA COUNTY, FLORIDA Case No: 2023MM 000212 Date of Offense: 12/17/2022 STATE OF FLORIDA VS CHAMPAYNE DENISE SMITH 4511 ARCH ST ORLANDO, FL 32808 Defendant PUBLIC DEFENDER 2 COURTHOUSE SQUARE SUITE 1600 KISSIMMEE, FL 34741 ATTORNEY BAIL… [show full stored text]	Court/case doc	284.3 KB	2024-12-14 14:34:52 uploaded 52d after created	no	Dropbox · History
Service of Document - SMITH, 2022-CF-009837-A-O 26 Nov 2024 135557 -0500.pdf E In the Circuit Court of the Ninth Judicial Circuit, in and for Orange County, Florida Division: Div 20 Case No: 2022-CF-009837-A-O Courtroom: 12-A State of Florida, Plaintiff, vS. CHAMPAYNE DENISE SMITH Defendant. Date of birth: 4/10/1987 COURT ORDER & SETTING / RESET NOTICE This cause came on thi… [show full stored text]	Court/case doc	33.4 KB	2024-11-29 16:47:26	no	Dropbox · History
Service of Document - SMITH, 2022-CF-009837-A-O 28 Aug 2024 094224 -0400.pdf 8/16/2024 10:14 AM FILED IN OFFICE TIFFANY M RUSSELL CLERK CIRCUIT COURT ORANGE CO FL IN THE CIRCUIT AND COUNTY COURT OF THE NINTH JUDICIAL CIRCUIT IN AND FOR ORANGE COUNTY, FLORIDA Court Case Number: 2022-CF-009837-A-O STATE OF FLORIDA, CHAMPAYNE DENISE SMITH DOB: 04/10/1987 Charge Description: GRA… [show full stored text]	Unclassified	1.2 MB	2024-09-18 15:11:27 uploaded 21d after created	no	Dropbox · History
Service of Document - SMITH, 2022-CF-009837-A-O 4 Sep 2024 170132 -0400.pdf In the Circuit Court of the Ninth Judicial Circuit, in and for Orange County, Florida Division: Div 20 Case No: 2022-CF-009837-A-O Courtroom: 12-A State of Florida, Plaintiff, VS. CHAMPAYNE DENISE SMITH Defendant. Date of birth: 4/10/1987 Not Guilty/Deny entered as to --. 1 GRAND THEFT THIRD DEGREE … [show full stored text]	Court/case doc	160.2 KB	2024-09-18 15:11:27 uploaded 14d after created	no	Dropbox · History
SMITH, CHAMPAYNE 1113 Santa Anita St - Google Maps.pdf 1113 Santa Anita St - Google Maps 8/7/24, 2:41 PM Google Maps 1113 Santa Anita St Collison Repair Gamble Dr. JC Pet Hotel FE Mollie Ra Elementary School Boys & Girls Club Walt Disney World Clubhouse Indialantic Dr Frisco Ci Jose Biva Ambassador Dr. elt Allegheny Ci Stebbins Ave s Bennington PI Grove… [show full stored text]	Unclassified	16.8 MB	2024-09-15 11:31:30 uploaded 39d after created	no	Dropbox · History
SMITH, CHAMPAYNE 3 EP V10.9.2024 - Orange.pdf Packet Completed By: RRAMOS Indemnitor: WANDA GRIFFIN Ind Add. 1113 SANTA ANITA ST Ind Home # (407) 300-0689 Social Security: _ 264-04-9103ACF#: 080620241910 City:_ORLANDO_ State: _ FL 32808 Ind Cell # (407) 300-0689 Zip: _ Email: WANDAGFRMDAOFC Relationship to Def.: MOTHER — How long known Def.: LIFE IA PN Mortgagee Deed ($17.00) • SIGNATURE BOND ONLY Vessel Title ($75.00 fee) Collateral Explained: _ Collateral in Amount of $ 0.00 • Cash • Check co \| MO Collateral held by Bondsman Surety Condition(s) of Bond: MUST CHECK IN EVERY TUESDAY VIA BVMA UNTIL BONDS ARE DISCHARGED CHAMPAYNE SMITH Defendant Name: dob: 04/10/87 Booking #. F 08/06/24 doa: sex: Execution Date: 8/6/24 Power No: AIA TRANSFER Bond Amount: _ PETIT THEFT 2 PRIOR CONVICTIONS Charge: $ 1,000.00 Premium: Case No: TBN Court Date: _ AIA TRANSFER Power No: Charge: FTA (PETIT THEFT) $ 100.00 Premium: Case No: AIA TRANSFER TBN Court Date: Power No: AIA TRANSFER Charge: LARCENY / GRAND THEFT $ 100.00 Premium: Case No: TBN Court Date: Detainer: _ Court: County: Time: Bond Amount: Detainer: _ Court: County: - Time: Bond Amount: Detainer: _ Court: County: _ Time: Continue to Next Paae 2024-22863 race: $ 10,000.00 COUNTY POLK TBN $ 1,000.00 COUNTY OSCEOLA TBN $ 500.00 CO / CIR OSCEOLA 23MM212 Agent: City: RAUL RAMOS ORLANDO Agent Lic No: State: W311154 FL Total Premium: Misc Charges: $ 1,200.00 $ 100.00 Money Received on Account: Balance $ 400.00 $3) 2024-2286380620241910 Total Liability: Total Charges: $ 900.00 Due Date: Received From: $ 11,500.00 $ 1,300.00 8/7/24 WANDA GRIFFIN CO BAIL BOND APPLICATION - INDEMNITOR COMPANY ALLEGHENY CASUALTY COMPANY P.O. Box 9810, CALABASAS, CA 91372-9810 TELEPHONE (800) 935-2245 BAIL 2 GO P.O. Box 592643, ORLANDO, FL 32859-2643 TELEPHONE (407) 254-5554 1. Name _ First WANDA DENESE GRIFFIN Middle Last 1113 SANTA ANITA ST 2. Residence Address. 3. How Long at Current Address 10YR Rent Free 4. Is Mortgage/Lease in your name? Yes. 5. Cell Phone # 407-300-0689 _ No. Cell Carrier 6. Employer RETIRED Length Any ownership greater than 20% in any Corporation, LLC, or S-Corp 7. Social Security No. 264049103 ID# G615-904-53-526-0 8. Have you ever filed Bankruptcy. My friends/family know me as NO ORLANDO 9. Gender Place of Birth 10. Have many years have you lived in FL? 11. Vehicle Year Vehicle Color 12. Relationship to Defendant Defendants Home Address ORLANDO City - _ State. FL _ Zip 32808 Lease _ Own X Landlord/Mortgagor Name When does Lease Expire _ Email WANDAGFRMDAOF@GMAI iPhone or Android ANDROID How Long with Cell No. Position Work # NO _ Any specialized license to work _ Wt. Ht 57 Race _B_Eye Color BRN Hair NO Do you have any judgements or liens against you currently _ If so, where NO NO Date of Birth 01/26/1953 US Citizen Marital Status SEP How Long LIFE NO NO Are you a convicted felon? Are you on any type of Probation or Parole ? Vehicle Make MOTHER Tag No. Vehicle Miles How long have you known Defendant SAME Defendants Cell Phone Number Amount Owed LIFE 407-497-4159 13. Emergency Contact Name Address Phone No. 13. Children Yes No Amount of children Ages Do kids reside with you 14. Attorney Phone No. PREVIOUS CLIENT May we reach out on the defendants behalf 15. How did you hear about us? Personal References First & Last Name ANDREW GRIFFIN 1._ 2. 3. 4. 5._ 6. JONITA ROBINSON HEAVEN THOMAS MYA SMITH Relationship HUSBAND NEICE GRAND DA GRAND DA City / State ORLANDO ORLANDO ORLANDO ORLANDO Phone 407-485-6457 407-230-6006 352-936-9118 321-795-0642 I hereby represent and warrant that the foregoing information is true, complete and correct and is made for the purpose of inducing International Fidelity Insurance Company/Allegheny Casualty Company to issue, or cause to be issued, bail bond(s) for 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 StandShi Print WANDA GRIFFIN ID# SSN DOB allegheny CASUALTY COMPANY PO Box 5600, Thousand Oaks, CA 91359 800.935.2245 info@aiasurety.com BAIL BOND AGREEMENT ("Agreement") PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE: %DIOT * 2 Orlando (Orange County) 16 RX- RKQ< RXQJ 3N2\ 2 LOQGRI) / MOI THIS IS A DOUBLE SIDED DOCUMENT READ ALL SIDES CAREFULLY 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 8/6/24 CHAMPAYNE SMITH Indemnitor Name(s) WANDA GRIFFIN Total Bond Amount $ $ 11,500.00 Total Premium $ $ 1,200.00 Power Number(s) AIA TRANSFER AIA TRANSFER ("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 8/6/24 Print Name CHAMPAYNE SMITH indemnior signature ten Destin Print Name WANDA GRIFFIN Indemnitor Signature Indemnitor Signature Print Name Print Name Indemnitor Signature Print Name Indemnitor Signature Print Name Si no puede leer ni entender Inglés, favor de marcar este cuadro. Check box and complete the (If you cannot read or understand English, please check this box.) 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 Orlando (Orange County) 3800 South John Young Pkwy Orlando, FL 32839 (407) 254-5554 Defendant Name CHAMPAYNE SMITH Power Numbers) Case Number AIA TRANSFER 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 bonds), 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 WANDA GRIFFIN Signed original to agent's bond file; Copy to defendant and each indemnitor Date 8/6/24 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: CHAMPAYNE SMITH ("Defendant"). On demands after date, for value received, I/We promise to pay to the order of Allegheny Casualty Company the sum of $ $ 11,500.00 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 numbers) AIA TRANSFER , POLK COUNTY, FLORIDA P/A numbers) AIA TRANSFER Haul Stiffer AIA TRANSFER Signature Signature WANDA GRIFFIN Maker Name Form# ACC.FL.0036 (10/21) 8/6/24 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). L Date Received 8/6/24 Depositor Name(s) WANDA GRIFFIN Depositor Address 1113 SANTA ANITA ST Power Number(s) Case Number AIA TRANSFERAIA TRANSFER Items) Received - describe below, specify condition Promissory Note, Signature Bail Bond Agreement Collateral funds - in form of SIGNATURE BOND ONLY If applicable, I acknowledge a Credit Card fee of positor FLORIDA USE ONLY Form# ACC.FL.0304-2 (01/23) Signature Print Name Santa trper WANDA GRIFFIN Receipt No.: ACFL- 080620241910 PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED Bail 2 GO Orlando (Orange County) 3800 South John Young Pkwy Orlando, FL 32839 (407) 254-5554 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) 300-0689 Defendant Name CHAMPAYNE SMITH Bond Amount $ 11,500.00 Amount or Estimated Value $ $ $$ 0.00 % in the amount of $ Signature Bail Producer Print Name L RAUL RAMOS Held By Bail Producer Bail Producer Bail Producer L L Surety Surety Surety 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 Receipt No.: AP- 2024-22863 PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE Bail 2 GO Orlando (Orange County) 3800 South John Young Pkwy Orlando, FL 32839 (407) 254-5554 Date Received 8/6/24 Payer Name Payment Method • Cash • Check • Credit Card • Money Order Credit Card Authorization Code Amount Received ($) $ 900.00 Payer Phone Number WANDA GRIFFIN (407) 300-0689 Defendant Bond Amount ($) CHAMPAYNE SMITH $ 11,500.00 Power Numbers) Case Number(s) AIA TRANSFER Court COUNTY COUNTY AIA TRANSFER Appearance Date TBN TBN Appearance Time TBN AIA TRANSFER Collateral Received Collateral Receipt Numbers) • Yes • No 080620241910 Itemized Expense(s) (if and as permitted by applicable law) Expense(s) $ Expense Amount $ 100.00 Bail Bond Premium Total Expense(s) $ $ 1,200.00 $ $ 1,300.00 $ Prior Payments) ($ $ Amount Received ($ $ Remaining Balance $ $900.00 $400.00 08185 Paid Form# ACC.0304-1 (10/21) Print Name WANDA GRIFFIN Received By Producer/Representative Signature Producer/Representative Print Name RAUL RAMOS ) ) PREMIUM RECEIPT and STATEMENT OF CHARGES I understand that the premium owing or paid is fully earned upon the Defendant's release from custody, and the fact that the Defendant may have been improperly arrested, re-arrested, the case dismissed, or the bail reduced shall not obligate the return or forgiveness of any portion of the premium except as otherwise provided by applicable law (if any) as stated in the Bail Bond allegheny CASUALTY COMPANY PO Box 5600, Thousand Oaks, CA 91359 800.935.2245 info@aiasurety.com FOR FURTHER ACTION ON THIS BOND NOTIFY: Bail 2 GO P.O. Box 592643 Orlando, FL 32859 Email: courtdates@bail2go.com Transfer agent dob: 04/10/87 doa: 08/06/24 seX: F race: B General Surety Appearance Bond Power Number Arrest Number IN THE COUNTY AIA TRANSFER 2024-22863 STATE OF FLORIDA VS: COURT CHAMPAYNE SMITH POLK COUNTY KNOW ALL MEN BY THESE PRESENTS: That we, the above captioned defendant as Principal, and Allegheny Casualty Company, a New Jersey corporation, as Surety are held and firmly bound unto the State of Florida and its successors, to the penal sum of ($) $ 10,000.00 for the payment whereof well and truly to be made we bind ourselves, our heirs, representatives, successors, and assigns firmly by these presents. The condition of this obligation is such that if said Principal shall appear on TBN at TBN the next Regular or Special term of the above court and shall submit to the said Court to answer a charge of: PETIT THEFT 2 PRIOR CONVICTIONS for case number and shall submit to orders and process of said court and not depart the same without leave, then this obligation to be void, else to remain in full force and virtue. Signed, sealed and delivered this 8/6/24 TAKEN BEFORE ME AND APPROVED BY ME: (L.S.) _, Clerk / Sheriff (Principal) Allegheny Casualty Company By By Agent / License Number Agent Name (Attorney in fact) (SURETY) W311154 RAUL RAMOS ANTO This bond not valid for deferred sentence, fines, pre-sentence investigation, pre-trial intervention programs or appeals STATEMENT OF BONDSMAN 1, the undersigned, am a duly licensed bail bond agent pursuant to Chapter 648, F.S., and have registered for the current year with the office of the Sheriff and Clerk of Court of the aforementioned county, and have filed a certified copy of my appointment by Power of Attorney for the Surety with the office of the Sheriff and Clerk of the Court of the aforementioned County. That said Principal of 1113 SANTA ANITA ST (Address) has (given or promised to give) the sum of ($) $ 1,000.00 as consideration for Bail Bond Number AIA TRANSFER filed with the Clerk of the above captioned court located in said county together with the (promise or receipt) of security belonging to WANDA GRIFFIN (Indemnitor(s)) as follows: (provide detailed description and source of security) (if none, so state). That a duly signed receipt has been given to the said Principal for the consideration given and/or that the said indemnitor has (also been) given a receipt for the security described above. (Bondsman) RAUL RAMOS (Agency) Bail 2 GO Orlando (Orange County) allegheny CASUALTY COMPANY PO Box 5600, Thousand Oaks, CA 91359 800.935.2245 info@aiasurety.com FOR FURTHER ACTION ON THIS BOND NOTIFY: Bail 2 GO P.O. Box 592643 Orlando, FL 32859 Email: courtdates@bail2go.com Transfer agent dob: 04/10/87 doa: 08/06/24 sex: F race: General Surety Appearance Bond Power Number Arrest Number IN THE_COUNTY AIA TRANSFER 2024-22863 STATE OF FLORIDA VS: COURT CHAMPAYNE SMITH OSCEOLA COUNTY KNOW ALL MEN BY THESE PRESENTS: That we, the above captioned defendant as Principal, and Allegheny Casualty Company, a New Jersey corporation, as Surety are held and firmly bound unto the State of Florida and its successors, to the penal sum of ($) $ 1,000.00 for the payment whereof well and truly to be made we bind ourselves, our heirs, representatives, successors, and assigns firmly by these presents. The condition of this obligation is such that if said Principal shall appear on TBN at TBN the next Regular or Special term of the above court and shall submit to the said Court to answer a charge of: FTA (PETIT THEFT) for case number AlA TRANSFER and shall submit to orders and process of said court and not depart the same without leave, then this obligation to be void, else to remain in full force and virtue. Signed, sealed and delivered this 8/6/24 TAKEN BEFORE ME AND APPROVED BY ME: _, Clerk / Sheriff (Principal) Allegheny Casualty Company (L.S.) ...., By By Agent / License Number Agent Name (Attorney in fact) (SURETY) W311154 RAUL RAMOS ANTO This bond not valid for deferred sentence, fines, pre-sentence investigation, pre-trial intervention programs or appeals STATEMENT OF BONDSMAN 1, the undersigned, am a duly licensed bail bond agent pursuant to Chapter 648, F.S., and have registered for the current year with the office of the Sheriff and Clerk of Court of the aforementioned county, and have filed a certified copy of my appointment by Power of Attorney for the Surety with the office of the Sheriff and Clerk of the Court of the aforementioned County. That said Principal of 1113 SANTA ANITA ST (Address) has (given or promised to give) the sum of ($) $ 100.00 as consideration for Bail Bond Number AIA TRANSFER filed with the Clerk of the above captioned court located in said county together with the (promise or receipt) of security belonging to WANDA GRIFFIN (Indemnitor(s)) as follows: (provide detailed description and source of security) (if none, so state). That a duly signed receipt has been given to the said Principal for the consideration given and/or that the said indemnitor has (also been) given a receipt for the security described above. (Bondsman) RAUL RAMOS (Agency) Bail 2 GO Orlando (Orange County) allegheny CASUALTY COMPANY PO Box 5600, Thousand Oaks, CA 91359 800.935.2245 info@aiasurety.com FOR FURTHER ACTION ON THIS BOND NOTIFY: Bail 2 GO P.O. Box 592643 Orlando, FL 32859 Email: courtdates@bail2go.com Transfer agent dob: 04/10/87 doa: 08/06/24 sex: F race: B General Surety Appearance Bond Power Number Arrest Number IN THE •CO / CIR AIA TRANSFER 2024-22863 STATE OF FLORIDA VS: COURT CHAMPAYNE SMITH OSCEOLA COUNTY KNOW ALL MEN BY THESE PRESENTS: That we, the above captioned defendant as Principal, and Allegheny Casualty Company, a New Jersey corporation, as Surety are held and firmly bound unto the State of Florida and its successors, to the penal sum of ($) $ 500.00 for the payment whereof well and truly to be made we bind ourselves, our heirs, representatives, successors, and assigns firmly by these presents. The condition of this obligation is such that if said Principal shall appear on TBN at 23MM212 the next Regular or Special term of the above court and shall submit to the said Court to answer a charge of: LARCENY / GRAND THEFT for case number and shall submit to orders and process of said court and not depart the same without leave, then this obligation to be void, else to remain in full force and virtue. Signed, sealed and delivered this 8/6/24 TAKEN BEFORE ME AND APPROVED BY ME: _, Clerk / Sheriff (Principal) Allegheny Casualty Company (L.S.) ......, By By Agent / License Number Agent Name (Attorney in fact) (SURETY) W311154 RAUL RAMOS This bond not valid for deferred sentence, fines, pre-sentence investigation, pre-trial intervention programs or appeals STATEMENT OF BONDSMAN 1, the undersigned, am a duly licensed bail bond agent pursuant to Chapter 648, F.S., and have registered for the current year with the office of the Sheriff and Clerk of Court of the aforementioned county, and have filed a certified copy of my appointment by Power of Attorney for the Surety with the office of the Sheriff and Clerk of the Court of the aforementioned County. That said Principal of 1113 SANTA ANITA ST (Address) has (given or promised to give) the sum of ($) $ 100.00 as consideration for Bail Bond Number AIA TRANSFER filed with the Clerk of the above captioned court located in said county together with the (promise or receipt) of security belonging to WANDA GRIFFIN (Indemnitor(s)) as follows: (provide detailed description and source of security) (if none, so state). That a duly signed receipt has been given to the said Principal for the consideration given and/or that the said indemnitor has (also been) given a receipt for the security described above. (Bondsman) RAUL RAMOS (Agency) Bail 2 GO Orlando (Orange County)	Indemnitor app (digital)	2.8 MB	2024-09-15 11:31:30 uploaded 26d after created	no	Dropbox · History
SMITH, CHAMPAYNE Agents File Checklist.pdf 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… [show full stored text]	Unclassified	226.6 KB	2024-09-15 11:31:30 uploaded 39d after created	no	Dropbox · History
Smith, Champayne D TLOxp.pdf TLOxp - Advanced 8/6/24, 8:22 PM Your Current Reference ID: NONE 1 Result Found for people named SMITH CHAMPAYNE born on 04/10/1987 in the United States. CHAMPAYNE DENISE SMITH , 37 Years Old (Clermont, FL, Orlando, FL CHAMPAYNE DENISE SMITH Possible Relatives Cities (06/30/2006 to 06/04/2024) Jazmi… [show full stored text]	Unclassified	74.2 KB	2024-09-15 11:31:30 uploaded 39d after created	no	Dropbox · History
SMITH, CHAMPAYNE EDP V10.9.1.2024 - Orange.pdf Packet Completed By: Juliet Castillo Defendant: Champayne Smith Social Security: 595-48-5747 Def Add. 1113 Santa Anita st _ City: Orlando State: Zip: 32808 Def Home # (407) 497-4159 _ Def Cell # (407) 497-4159 Email: Chamy2glokk@icloud.con Condition(s) of Bond: MUST CHECK IN EVERY TUESDAY VIA BVMA U… [show full stored text]	Defendant app (digital)	1.8 MB	2024-09-15 11:31:30 uploaded 26d after created	no	Dropbox · History
SMITH, CHAMPAYNE INDEM ID.pdf Florida USA DRIVER LICENSE G615-904-53-526-0°CLĄSsE GRIFFIN 2WANDA DENESE 1814 RILEY AVE ORLANDO, FL 32805-5110 осв 01/26/1953 15SEX F # EXP 01/26/2027 16HGT 5'-07* 12 REST B 9a END NONE 4a iSS 01/28/2019 500 X652309143283 REPLACED 09/14/2023 Operation of a motor vehicle constitutes consent to any s… [show full stored text]	State ID	102.5 KB	2024-09-15 11:31:30 uploaded 40d after created	no	Dropbox · History
SMITH, CHAMPAYNE MUGSHOT SEARCH.pdf Search Florida Florida Jail Arrest Records Home Florida Bookings Counties Search Contact Face Search Criminal Record Search First Name Last Name State Any State V Search Per page (14 $ Champayne Smith Champayne Smith Champayne Smith Champayne Smith arrests. org Orange 126 Views Champayne Smith arres… [show full stored text]	Court/case doc	1.6 MB	2024-09-15 11:31:30 uploaded 40d after created	no	Dropbox · History
SMITH, CHAMPAYNE MUGSHOT.jpeg	Court/case doc reason: low-text-confidence	17.6 KB	2024-09-15 11:31:30 uploaded 40d after created	yes	Dropbox · History
SMITH, CHAMPAYNE ORANGE CO CLERK.pdf Orange County Clerk of Courts Records Search 2 Print show 15 al entries # Case Number 1 2022-TR-194896-A-O 8/6/24, 7:07 PM Search Result: 72 cases 2 3 4 5 6 7 8 9 Search: 04/10/1987 2022-TR-194893-A-O 2022-TR-194891-A-O 2022-TR-194889-A-O 2022-TR-194888-A-O 2022-TR-194886-A-O 2022-TR-194883-A-O 2022… [show full stored text]	Court/case doc	49.7 KB	2024-09-15 11:31:30 uploaded 40d after created	no	Dropbox · History
SMITH, CHAMPAYNE OSCEOLA CO CLERK.pdf 2023 MM 000212 - STATE OF FLORIDA vs. SMITH, CHAMPAYNE DENISE 8/6/24, 7:06 PM PHOR SEF 2023 MM 000212 - STATE OF FLORIDA vs. SMITH, CHAMPAYNE DENISE D Print Summary (../DetailsPrint/3247490?digest=djtOlnjTDdQqp8b1ZVvF5Q) →) Login - Summary Remember - SILMMARY y History 1 Charges (/BenchmarkWeb/Home.… [show full stored text]	Court/case doc	92.3 KB	2024-09-15 11:31:30 uploaded 40d after created	no	Dropbox · History
SMITH, CHAMPAYNE PREMIUM PROOF.DNG	Unreadable (unsupported file type -- not a PDF/JPG/PNG) reason: unsupported-filetype	25.5 MB	2024-09-15 11:31:30 uploaded 39d after created	yes	Dropbox · History
SMITH, CHAMPAYNE.pdf VERIFY FIRST - THIS DOCUMENT IS PRINTED IN BLUE & BLACK INKS Only the original Power of Attorney will bind this surety. POWER OF ATTORNEY Allegheny Casualty Company POWER NUMBER AS15K-468472 PO Box 5600, Thousand Oaks, CA 91359 THIS POWER VOID IF NOT USED BY: December 1800935-2242024 poa@aiasurety.c… [show full stored text]	Executed Power (PoA)	3.2 MB	2024-09-15 11:31:30 uploaded 38d after created	no	Dropbox · History
Transfer_Bond_Confirmation - 2024-08-07T093334.035.pdf AIA Surety Transfer Bond Confirmation Date: To: 8/7/2024 Raul Fax: Authorization: (866) 425-8119 61 abbe53-262373 This fax confirms that your office requested the following transfer bond: Request Date: Defendant: County: Bond Amounts): 08/07/2024 Champayne Smith Polk $1,000.00 $500.00 $1,000.00 Tran… [show full stored text]	Unclassified	57 KB	2024-09-15 11:31:30 uploaded 39d after created	no	Dropbox · History
Transfer_Bond_Confirmation.pdf AIA Surety Transfer Bond Confirmation Date: To: 8/7/2024 Raul Fax: Authorization: (866) 425-8119 61 abbe53-262373 This fax confirms that your office requested the following transfer bond: Request Date: Defendant: County: Bond Amounts): 08/07/2024 Champayne Smith Polk $10,000.00 $500.00 $1,000.00 Tra… [show full stored text]	Unclassified	57 KB	2024-09-15 11:31:30 uploaded 39d after created	no	Dropbox · History

Bail 2 GO — Compliance Dashboard

SMITH, CHAMPAYNE 08:06:2024 - RR

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