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a allegheny CASUALTY COMPANY PO Box 5600, Thousand Oaks, CA 91359 800.935.2245 info@aiasurety.com THIS IS A 4-PAGE, DOUBLE SIDED DOCUMENT READ CAREFULLY AND COMPLETE BAIL BOND APPLICATION - DEFENDANT PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE: Bail 2 GO - Orlando P.O. Box 592643, Orlando, FL 32859 (407) 254-5554 Defendant Name Lurinso A Tolber Home Phone Number My friends / family know me as Cell Phone Number Work Phone Number (614) 316-1911 Current Full Address, City, State and Zip 4388 LANDMARK RD, GROVEPORT, FL OHIO From To Landlord Name (if applicable) Email lorenzo_elliot@yahoo.com • Own • Rent Landlord Phone Number tion Former Full Address, City, State and Zip 9 From To Landlord Name (if applicable) • Own • Rent Landlord Phone Number • M • F Height Birth Date 11/07/1992 Weight Birth Place Social Security Number 272-96-4298 Eye Color Tattoos / Piercings Hair Color Glasses Facial Hair Scars / Distinguishing Marks Medical Conditions / Disabilities Years in City Years in State Former City Driver's License / ID Number TN733793 Former State U.S. citizen? Alien Number •Yes No State Issued OH How long in US? Arrest Date Booking Name (if different) Booking Number 2023-00001278 Arresting Agency Court Name Judicial District Jail Location Brevard County Jail Complex County State Case Number Appearance Date Time Battery - Touch or Strike • Provous rest Cages 1 Provous Are 2 Changes Probation / Parole Officer Name Arrest date Arrest Location Arrest date Arrest Location Phone Number Pending Charges in Other Counties Bonded before by On parole/probation? Currently on bond? Previously failed to appear? • Yes • No • Yes • No • Yes •I No When Co-Defendant Name Co-Defendant Phone Number Form# ACC.0301 (11/22) Page 1 of 4 Print Form Reset Form Current Employer Position Supervisor's Name Position Union Military Branch • Single Significant Other Name • Married Cohabitating Significant Other Current Full Address, City, State and Zip Home Phone Number Cell Phone Number I same one are em Former Significant Other Name Former Significant Other Current Full Address, City, State and Zip Home Phone Number Cell Phone Number Facebook Username Twitter Username Linkedin Username i Password Password Password Year Make Model Color i marn many Insurance Company / Agent Financial Institution • Separated DOB DOB Form# ACC.0301 (11/22) Page 2 of 4 Phone Number Phone Number Local Number Active • Yes • No • Divorced DOB Email Social Security Number Phone Number Phone Number DOB Email Social Security Number Other Account Password Plate Number Balance owed Phone Number Phone number Average Balance How Long How Long Discharge Date • Widowed Years together Years together Username State • Savings • Checking Print Form Reset Form Reference Name Full Address, City, State and Zip Reference Name Full Address, City, State and Zip Reference Name Full Address, City, State and Zip Reference Name Full Address, City, State and Zip Reference Name Full Address, City, State and Zip DOB Cell Phone Number DOB Cell Phone Number DOB Cell Phone Number DOB Cell Phone Number DOB Cell Phone Number Relationship to Defendant Work Phone Number Relationship to Defendant Work Phone Number Relationship to Defendant Work Phone Number Relationship to Defendant Work Phone Number Relationship to Defendant Work Phone Number I hereby represent that the foregoing information is true, complete and correct and is made for the purpose of inducing Allegheny Casualty Company to issue, or cause to be issued, bail bond(s) for the defendant referred to herein. Signed, sealed and delivered this Authorized Signatures Defendant Signature Defendant Print Name Lurinso A Tolber Driver's License Number TN733793 Social Security Number 272-96-4298 Birth Date 11/07/1992 SEE NEXT PAGE FOR APPLICABLE FRAUD WARNINGS. Form# ACC.0301 (11/22) Page 3 of 4 Print Form Reset Form IMPORT A FRAUD WARNIN ALABAMA RESIDENTS Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or who knowingly presents false information in an application for insurance is guilty of a crime and may be subject to restitution fines or confinement in prison, or any combination thereof. ARKANSAS RESIDENTS Any person who knowingly presents a talse or traudulent claim tor pavment tor a loss or benetit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. CALIFORNIA RESIDENTS For your protection California law requires the following to appear on this form: Any person who knowingly presents false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison. FLORIDA RESIDENTS Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree. LOUISIANA AND MAINE RESIDENTS It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties may include imprisonment, fines or a denial of insurance benefits. MARYLAND RESIDENTS: Any person who knowingly or willfully presents a false or fraudulent claim for payment of a loss or benefit or who knowingly or willfully presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. NEW JERSEY RESIDENTS Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties. NEW MEXICO RESIDENTS Any person who knowingly presents a false or fraudulent claim for payment or a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to civil fines and criminal penalties. NEW YORK RESIDENTS Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime, and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation. OHIO RESIDENTS Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an applicatior or files a claim containing a false or deceptive statement is guilty of insurance fraud OKLAHOMA RESIDENTS WARNING: Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes any claim for the proceeds of an insurance policy containing any false, incomplete or misleading information is guilty of a felony PENNSYLVANIA RESIDENTS RHODE ISLAND, TENNESSEE, VIRGINIA, WASHINGTON, AND WEST VIRGINIA RESIDENTS defrauding the company. Pendits say nolde imprisonment, tines or a denial of insurance benefiny for the purpose of Form# ACC.0301 (11/22) Page 4 of 4 Print Form Reset Form allegheny CASUALTY COMPANY PO Box 5600, Thousand Oaks, CA 91359 800.935.2245 info@aiasurety.com THIS IS A DOUBLE SIDED DOCUMENT READ ALL SIDES CAREFULLY BAIL BOND AGREEMENT (" Agreement") PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE: Bail 2 GO - Orlando P.O. Box 592643, Orlando, FL 32859 (407) 254-5554 Agreement Details 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: 01/30/2023 Lurinso A Tolber Indemnitor Name(s) Lurinso Tolber, Marlon Elliot Total Bond Amount $ 500.00 Total Premium $ 100.00 Power Numbers) N/A ("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 Indemnitor Signature Print Name Lurinso A Tolber Print Name Indemnitor Signature Indemnitor Signature Print Name Print Name Indemnitor Signature Indemnitor Signature Print Name Print Name Si no puede leer ni entender Inglés, favor de marcar este cuadro. Check box and complete the following if translation is required Translation Certification. The undersigned translator makes this affidavit and hereby certifies, under penalty of perjury, that he/she read verbatim and translated this entire document, including the reverse side, and all related bond application documents including disclosures, promissory notes, security instruments and trust deeds, to the Indemnitor signing below in his/her primary language. Translator Print Name Translator Signature Translator Full Address Date Confirmo por mi colocación de mis iniciales que las dos caras de este acuerdo han sido traducidos completamente a mi satisfacción. (I confirm by my affixing my initials that this contract has been translated to my satisfaction.) INDEMNITOR Initials Form# ACC.FL.0307 (10/21) READ ALL TERMS AND CONDITIONS ON THE FRONT AND BACK OF EACH PAGE Page 1 of 4 Print Form Reset Form And Conditi 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. Defendant 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. 3. Surety shall have control and jurisdiction over the Defendant during the term for which the Bond is in effect and shall have the right to apprehend, arrest and surrender the Defendant to the proper officials at any time as provided by law and/or this Agreement. It the Detendant is surrendered betore a tailure to appear in Court, and for a reason other thar as stated in paragraph 4, you may be entitled to a retund of the Bond premium it required by applicable law it 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 your obligations o 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 suretv b Detendant moves trom nis/ner current address without prior written consent of the surety, or Detendant Tall: o notify Surety of any changes in address; (c) Defendant commits any act that constitutes reasonable evidence of the intention to cause a torteiture of the Bond or Detendant's tailure to appear in Court as required: (d Detendant is arrested and incarcerated for any other oftense (other than a minor traffic violation); (e) Detendant or an Indemnitor makes any materially talse statement in any material submitted to surety tor the Bond cludina the Bail Bond Application and Indemnitor Application; (f The bail for Defendant is increased; g ndemnitor requests the surrender to custody of the Defendant; and/or (h) There is a material increase in th 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 Defendant to custody is required for any reason, including the failure to appear by Defendant at any required Court proceeding or hearing, Defendant understands, agrees, and acknowledges that such apprehension and surrender involves risk of harm to Defendant 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, losses yany a pass agains Surely ling all agents neployees there arsing or or rea 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, or 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 tortelture ot, or ludament on, the Bond, plus any related court costs, interest anc aal tees incurred; (b any tugitive recoverv tee it there is a torteiture of the Bond (which tee is tvpically ten to twenty percent [10-20%] of the amount of the Bond plus any out of pocket expenses); (c) any and all costs incurred to extradite and/or apprehend and return Defendant to custody; and/or (d) if a collection action is required 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 any action against you as to the propriety of such payment and as to the extent of your liability to Surety for such payment hereunder. Further, you will, upon demand, place with Surety the requisite cash funds to meet any Liabilities (including a pending unpaid judgment or forfeiture demand), whether the demand is made before or after Surety has paid or advanced such funds. . Subiect to applicable law it anv). anv collateral (real or personal. includina cash or securities) pledaed to or depositec with Suretv as security for the obliaations under this Agreement ("Collateral of any and all sums due to Surety for any and all Liabilities sustained, paid or incurred by Surety. You authorize the or any part thereof, in order to pay or reimburse the Suretv for any and all the Bond and/or to place the Suretv in cash funds so as to protect the Suretv against the payment of any Liabilities, including any claim, demand, loss, or judgment arising out of the Bond, even if the Suretv has not paid any such Liability. Subiect to applicable law (if anv). the Suretv mav make any such sale, at its discretion, at public or private sales, and without demand, notice or advertisement of the time and place of said sale. anc 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 satisfactory Collateral so that the total value of the Collateral shall equal the value of the Collateral at the time of the initial pledae or deposit. Subject to applicable law (if any), if you fail to deposit such additional Collateral, the Surety shall have the full right, power and authority, without further demand or notice, to sell, assign and deliver the whole or any part of such Collateral, including any substituted or additional Collateral, at public or private sale, at its option, and without demand, notice or advertisement, and also with the right to purchase said Collateral at any such sale, freed and discharged from any equity or redemption as provided by applicable law. 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 Print Form Reset Form Terms And Conditions (continued from previous page) whether or not the Surety is entitled to be indemnified at the time of the entry, recording or filing of such COJ. If 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 remedv. 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 trom 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 and deliver to Surety a legal release of claims upon the return by Surety of the Collateral to you. † the Surety deems it necessary to make any outlay to protect any Collateral or security in its possession, whether for real or personal property, you authorize the Surety to do so, and you agree to indemnify and reimburse the Surety for 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 for 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 consent from you. Subject to any limitations imposed upon Assignee by the Surety, Assignee shall have the right to enforce in any suit, foreclosure, action, proceeding or otherwise any of the right of the Surety herein or arising out of any of the transactions contemplated hereby, and you shall not, and expressly waive any right to, assert the claim or defense 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, Reporting Act) and any local or state law relating to Surety obtaining, and you consent to and authorize Surety to obtain, any and all private or public intormation and/or records concerning you trom any party or agency, private or governmental (local, state or federal), including, but not limited to, credit reports, Social Security Records, criminal cIvil records, driving records, tax records, records, medical records, school records, worker or governmental (odal, state or federal contacted by surety to turns to Surely or Bail Producer, in accordance wate 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 Defendant 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 the il Compilance by belondant win the flowing terms and conting in period, and the Bond contined upon (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 information as required by Court Order or process; (e) Surety, including its agents and representatives, will be and (f YOU WILL NOT HAVE THE AND ANY APPLICABLE BOND EMISSION PERIOD KING DURING THE PERIOD THE BOND IS IN FORCE 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 tederal law, then such provisior shall automaticallv be deemed to have been revised to comply with such law so as to provide Suretv with the maximum rotection from any Liabilities. The invalidity or unentorceability ot any provision herein (or portion thereot) shall in n vay 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 agreement between the Surety and you. All statements, representations, promises, agreements, and affirmations made by the Surety or Bail Producer, or any representative, employee or agent, thereof prior to or contemporaneously with the execution of this Agreement are contained within this document, Agreement, are of no force or effect whatsoever in determining the rights, obligations and/or liabilities between the 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 Print Form Reset Form 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 happenina ot anv one of the tollowing events shall constitute a breach c Defendant's obligations to uretv. and suretv shall have the raht to immediate v appreheno. arrest and surrende Defendant, and no person shall have any right to any refund of premium whatsoever. The events which constitute a oreach of Defendant's obligations hereunder are: a) If Defendant departs the jurisdiction of the Court without the written consent of the Court and Surety or Bai Producer; (b) If Defendant moves from one address to another within the State of Florida without notifyin Surety or Bail Producer in writing prior to moving; (c) If Defendant commits any act which constitutes reasonable evidence of Detendant's intention to cause a torteiture of the Bondia It Detendant is arrested and incarcerated for any offense other than a minor traffic violation; or (e) If Defendant makes any material false statement in the Agreement. Division of Consumer Services, Bail Bond Section, 200 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. . For good ana valuable consideration, vou agree to indemnıty Supplemental Terms etendant as a condition ot the bono and lo the ball Producer's and suretv's powers relatino to the cancellation of tr 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 filing of motions; (c) Documented transportation and lodging expenses outside the jurisdiction of the court; (d) for housing, re-arrest, transportation and extradition; and (e) A maximum fee of $100 for a surrender allowed by law when there has seen no torteiture ot 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. 0. Suretv shall be entitled to deduct trom collatera held or anv return premium all tees. expenses. ano charde uthorized bv applicable law. includina Florida Administrative Code 69B-221.105 a conflict between the terms and conditions of the Agreement and this Supplement, this Supplement shall control. Form# ACC.FL.0307 (10/21) Page 4 of 4 Print Form Reset Form 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 P.O. Box 592643, Orlando, FL 32859 (407) 254-5554 Defendant Name Lurinso A Tolber Power Number(s) N/A Case Number As principal (defendant) and/or indemnitor (guarantor) on a bail bond, you must be given a copy of any collateral documents that you sign relating to the above bond(s). When all agreements have been fulfilled, bond is discharged in writing by the court, and without loss expense on the bond(s), your collateral will be returned to you. BE AWARE: YOUR COLLATERAL IS AT RISK if the principal fails to appear in court or if the principal commits any breach (violation) of agreement. ANY OF THE FOLLOWING HAPPENINGS IS A BREACH OF AGREEMENT: 1. If principal fails to appear in court; 2. If principal shall depart the jurisdiction of the court without the written consent of the court and the Surety, or its agent; 3. If principal shall move from one address to another without notifying the Surety, or its Agent, in writing, prior to said move; 4. If principal shall commit any act which shall constitute reasonable evidence of principal's intention to cause a forfeiture of the bond (s); 5. If principal is arrested and incarcerated for any offence other than a minor traffic violation; 6. If principal shall make any material false statement in the application; 7. If principal shall violate any special restriction or condition of the bond(s) imposed by the Court. For general information regarding your collateral, contact the agency as shown on the top of this sheet. 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 **** I/We have received a copy of this information sheet. I/e have received a copy of all collateral documents that I/We signed regarding the above bond(s). Defendant Signature Indemnitor Signature Print Name Date Date Signed original to agent's bond file; Copy to defendant and each indemnitor Form# ACC.FL.0028 (10/22) Page 1 of 1 Print Form Reset Form allegheny CASUALTY COMPANY PO Box 5600, Thousand Oaks, CA 91359 800.935.2245 info@aiasurety.com PRIVACY NOTICE PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE: Bail 2 GO - Orlando P.O. Box 592643, Orlando, FL 32859 (407) 254-5554 This Privacy Notice applies to your non-public personal information (personal information") received by Allegheny Casualty Company and/or AlA Holdings, Inc., as applicable, ("Surety"), through that 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: THE INFORMATION WE COLLECT: The Bail Producer is a licensed, independent contractor who is appointed by us to write bail. Prior to issuing a bail bond, the Bail Producer will collect, and in some cases, transmit to us your personal information. Your personal information is obtained from a variety of sources: • Applications and other forms (e.g., name, address, social security number, employment information, family member information, assets, income, and property locations and values) and electronically if you use our website or web-based date - our website uses cookies to collect individual information about you and your website usage); • Transactions and experiences with us and others, (e.g., credit card and account balances, and payment history); and • Consumer reporting agencies, medical providers, or others (e.g., credit score, background checks, and medical and employment information). HOW WE USE & PROTECT PERSONAL INFORMATION: Your personal information will be used to process the bail bond application, underwrite and post the bond and resolve bond claims or breaches of contract. We may provide your personal information to others working with us who need this information for these purposes, such as attorneys and investigators. Your personal information is used to assess the risk of the bail bond transaction, protect against fraud, or generally to effect, administer or enforce the terms of the bail bond transaction. Only authorized personnel are permitted to access your personal information. We convey to our employees and appointed Bail Producers the need to protect your personal information and require our outside vendors and service providers to keep your personal information confidential and to use it only to provide the services we have asked them to perform. PARTIES TO WHOM WE MAY DISCLOSE INFORMATION: We do not disclose your personal information to anyone except as permitted/required by law - for example, to industry regulators, law enforcement agencies, credit bureaus, subpoena, and third parties that assist us in the bail bond process and underwriting. We do not sell your personal information to anyone, and do not share your personal information with any companies or organizations that would use it to contact you about their products and services. CONFIDENTIALITY AND SECURITY: We maintain physical, electronic and procedural safeguards to protect your personal information. We ensure that your personal information is treated responsibly and consistent with our privacy policies. We also restrict access to your personal information within our organization to those persons who must have the information to provide services to you or to conduct our business. Persons who have access to your personal information may use it only for our business purposes. We safeguard your personal information in accordance with applicable laws. You have a right to review your personal information and to request that we correct, amend or delete such information on file. WEB PRIVACY: When you visit AlA's website at (www.aiasurety.com), the Web server automatically collects and maintains statistical information from our site's data logs that concern network traffic flow and volume. The information that is collected does not identify personal information. The collected information is used to improve the usefulness of the web site. We reserve the right to change this Privacy Notice at any time. The most up to date version of our Privacy Notice can be found on AIA's website. CALIFORNIA CONSUMER PRIVACY ACT: For California Residents, please visit www.aiasurety.com/CCPA to access our complete California privacy statement under the CCPA. If you would like a full copy of the policy, please contact the Surety at (818) 223-3308 or privacy@aiasurety.com. FURTHER INFORMATION: If you have any questions about how we use the information we collect, please write to us at: AIA Compliance Department, PO Box 5600, Thousand Oaks, CA 91359. Indemnitor / Defendant Signature [Indemnitor / Defendant Printed Name Date Lurinso A Tolber Form# ACC.0027 (10/21) *•g4 Page 1 of 1 Print Form Reset Form 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- SOC202301311245 PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE Bail 2 GO - Orlando P.O. Box 592643, Orlando, FL 32859 (407) 254-5554 Date Received 01/30/2023 Payer Name Lurinso A Tolber Defendant Lurinso A Tolber Power Number(s) N/A Court Payment Method • Cash Check • Credit Card • Money Order Credit Card Authorization Code Amount Received ($) N/A Payer Phone Number (614) 316-1911 Bond Amount $) 500.00 Appearance Date Itemized Expense(s) (if and as permitted by applicable law) Transfer/Posting Fee Case Numbers) Appearance Time Expense Amount $ 100.00 $ $ $ * 08185 Form# ACC.0304-1 (10/21) Payer Signature Print Name Lurinso A Tolber Collateral Received Collateral Receipt Numbers) • Yes • No 6312-8717, 6312-8719 Bail Bond Premium $ 100.00 ° Total Expense(s) $ 100.00 Prior Payments) ($200.00 Amount Received ($ N/A Remaining Balance $ 0.00 Producer/Representative Signature Producer/Representative Print Name ) PREMIUM RECEIPT and STATEMENT OF CHARGES I understand that the premium owing or paid is fully earned upon the Defendant's release from custody, and the fact that the Defendant may have been improperly arrested, re-arrested, the case dismissed, or the bail reduced shall not obligate the return or forgiveness of any portion of the premium except as otherwise provided by applicable law (if any) as stated in the Bail Bond Agreement. COLLATERAL RECEIPT allegheny CASUALTY COMPANY PO Box 5600, Thousand Oaks, CA 91359 800.935.2245 info@aiasurety.com Receipt No.: ACFL- 6312-8719 PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE: Bail 2 GO - Orlando P.O. Box 592643, Orlando, FL 32859 (407) 254-5554 Type • Deposit of collateral: Depositor hereby acknowledges receipt of • Return of collateral: Depositor hereby surrenders the original and acknowledge a copy of this document and agrees to the terms on the reverse he return and receipt of collateral listed herein and that the collateral has bee side. The collateral identified below is deposited as security for the bail bond(s), premium owed, if any, and all lawful expenses Ties bai produce from any luther lability or responsibily i relation the or tara. incurred due to underwriting the referenced bail bond(s). Returning collateral from receipt numbers) Date Received 01/29/2023 Depositor Name(s) Lurinso A Tolber Depositor Address 4388 LANDMARK RD, GROVEPORT, FL OHIO Power Number(s) N/A Depositor Phone Number (614) 316-1911 Defendant Name Lurinso A Tolber Case Number Item (s) Received - describe below, specify condition Promissory Note, Signature Bail Bond Agreement Funds - in form of • Cash • Check If applicable, I acknowledge a Credit Card fee of Signature • Money Order Bond Amount 500.00 Amount or Estimated Value Held By $ 500.00 • Bail Producer Surety $ Bail Producer Surety 7 Credit Card $ Bail Producer Surety % in the amount of $ Signature FLORIDA USE ONLY Form# ACC.FL.0304-2 (10/22) Print Name Lurinso A Tolber Print Name Jessica Bolden 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 alien 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. CONTINGENT PROMISSORY NOTE nis Contingent Promissorv Note ("Note) is beina executed bv the undersianed "Maker') to secure Alleahenv Casualt ompany, as surety, upon tortelture or estreature or the surety bond s) posted on benalt or detendan Lurinso A Tolber ("Defendant"). On demands after date, for value received, I/We promise to pay to the order of Allegheny Casualty Company the sum of $ 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) COUNTY, FLORIDA PIA number(s) N/A Signature Lurinso A Tolber Maker Name Form# ACC.FL.0036 (10/21) Signature Date Maker Name Date *08212* Print Form Reset Form

File	Classified as	Size	Modified	OCR	Links
(JB) Bail Bond Agreement for Luring Tolber - signed.pdf INTERNATIONAL FIDELITY INSURANCE COMPANY ALLEGHENY CASUALTY COMPANY P.O. BOX 9810, CALABASAS, CA 91372-9810 TELEPHONE (800) 935-2245 PRODUCER PRODUCER NAME, ADDRESS, PHONE AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE: Bail 2 GO Orlando P.O. Box 592643, Orlando, FL 32859 Office: 407… [show full stored text]	Defendant app (digital)	887.8 KB	2023-05-17 12:47:34 uploaded 106d after created	no	Dropbox · History
attachment1 2.PDF Jeannie Kyle From: Sent: To: Subject: Attachments: BAKER BAILBONDS < bakerbail@outlook.com> Monday, February 20, 2023 8:39 AM Imaging court notice Image.jpeg Hello. Attached is another court date for a bond we posted for Nathaniel S Zackery Agency Sincerely, Scott Townsend Baker Bail Bonds Get Outlo… [show full stored text]	Unclassified	733.6 KB	2023-05-17 12:47:34 uploaded 83d after created	no	Dropbox · History
attachment1 3.PDF Jeannie Kyle From: Sent: To: Subject: Attachments: BAKER BAILBONDS <bakerbail@outlook.com> Friday, March 10, 2023 1:54 PM Imaging OTB court notices Image jpeg; Image jpeg I have court notices for two OTB's posted in Brevard coming up on 3/15 and 3/16. See attached Scott Townsend Baker Bail Bonds Get… [show full stored text]	Unclassified	555.3 KB	2023-05-17 12:47:34 uploaded 64d after created	no	Dropbox · History
attachment1 4.PDF STATE OF FLORIDA IN THE COUNTY COURT, IN AND FOR BREVARD COUNTY, FLORIDA Case Number: 05-2023-MM-013515-AXXX-XX VS. LURINSO A. TOLBER Participant ID Number: 4158223 Filed in Open Court on May 12, 2023 10:27 am. J Batten, Deputy Clerk 36474431 NOTICE TO APPEAR FOR DOCKET SOUNDING You are hereby notif… [show full stored text]	Unclassified	881.1 KB	2023-06-02 07:05:00	no	Dropbox · History
attachment1.PDF Jeannie Kyle From: Sent: To: Subject: Attachments: BAKER BAILBONDS < bakerbail@outlook.com> Monday, February 20, 2023 8:39 AM Imaging court notice Image.jpeg Hello. Attached is another court date for a bond we posted for Nathaniel S Zackery Agency Sincerely, Scott Townsend Baker Bail Bonds Get Outlo… [show full stored text]	Unclassified	733.6 KB	2023-05-17 12:47:34 uploaded 85d after created	no	Dropbox · History
Check # 6445.jpg DOCUMENT CONTAINS COLORED BACKGROUND ON WHITE PAPER, "VOID" FEATURE, SIMULATED WATERMARK (REVERSE SIDE) MICRO-PRINT BORDER. PLEASE POST THIS PAYMENT FOR OUR MUTUAL CUSTOMER Account: PAYMENT $485.00 4/630 AXIOM SURETY CORP DBA BAIL 2 GO STE A 3800 S JOHN YOUNG PKWY ORLANDO, FL 32839-8620 MEMO: Collat… [show full stored text]	Image (unclassified)	133.8 KB	2024-07-27 23:48:55	no	Dropbox · History
CRC Confirmation 7:7:24 .pdf 7/7/24, 9:30 AM Payment Confirmation Bank of America I Online Business Suite I Bill Pay I Payment Confirmation Payments Submitted Amani Hack amanihack@gmail.com Beethoven Marhone neyoo716@gmail.com Gloria Souders gsouders@hotmail.com Marlon Elliott tamekae4968@gmail.com Your $500.00 payment from Col… [show full stored text]	Unclassified	158.1 KB	2024-07-07 13:32:34	no	Dropbox · History
Hearing Date Received for Lurinso Tolber 03012023 Tue, 21 Feb 2023 191910 +0000 (UTC).PDF Jeannie Kyle From: Sent: To: Subject: Attachments: BAKER BAILBONDS < bakerbail@outlook.com> Monday, February 20, 2023 8:39 AM Imaging court notice Image.jpeg Hello. Attached is another court date for a bond we posted for Nathaniel S Zackery Agency Sincerely, Scott Townsend Baker Bail Bonds Get Outlo… [show full stored text]	Unclassified	733.6 KB	2023-05-17 12:47:34 uploaded 85d after created	no	Dropbox · History
Hearing Date Received for Lurinso Tolber 03162023 Fri, 10 Mar 2023 230407 +0000 (UTC).PDF Jeannie Kyle From: Sent: To: Subject: Attachments: BAKER BAILBONDS <bakerbail@outlook.com> Friday, March 10, 2023 1:54 PM Imaging OTB court notices Image jpeg; Image jpeg I have court notices for two OTB's posted in Brevard coming up on 3/15 and 3/16. See attached Scott Townsend Baker Bail Bonds Get… [show full stored text]	Unclassified	555.3 KB	2023-05-17 12:47:34 uploaded 68d after created	no	Dropbox · History
Hearing Date Received for Lurinso Tolber 05122023 Wed, 03 May 2023 204926 +0000 (UTC).PDF Brianna Alanis From: Sent: To: Subject: Attachments: Follow Up Flag: Flag Status: BAKER BAILBONDS <bakerbail@outlook.com> Wednesday. May 3, 2023 10:16 AM Imaging OTB court notices Image. jpeg, Image.jpeg Follow up Flagged Please find attached two court notices for transfer bonds posted in Brevard Co… [show full stored text]	Unclassified	588.1 KB	2023-05-17 12:47:34 uploaded 14d after created	no	Dropbox · History
Hearing Date Received for Lurinso Tolber 06092023 Thu, 01 Jun 2023 200420 +0000 (UTC).PDF STATE OF FLORIDA IN THE COUNTY COURT, IN AND FOR BREVARD COUNTY, FLORIDA Case Number: 05-2023-MM-013515-AXXX-XX VS. LURINSO A. TOLBER Participant ID Number: 4158223 Filed in Open Court on May 12, 2023 10:27 am. J Batten, Deputy Clerk 36474431 NOTICE TO APPEAR FOR DOCKET SOUNDING You are hereby notif… [show full stored text]	Unclassified	881.1 KB	2023-06-07 05:17:27 uploaded 5d after created	no	Dropbox · History
Hearing Date Received for Lurinso Tolber 07142023 Fri, 07 Jul 2023 230436 +0000 (UTC).PDF OTB STATE OF FLORIDA VS. LURINSO A. TOLBER Participant ID Number: 4158223 IN THE COUNTY COURT, IN AND FOR BREVARD COUNTY, FLORIDA Case Number: 05-2023-MM-013515-AXXX-XX Filed in Open Court on June 9, 2023 10:02 am. J Sikes, Deputy Clerk 36609496 NOTICE TO APPEAR FOR DOCKET SOUNDING You are hereby no… [show full stored text]	Unclassified	637.2 KB	2023-07-14 06:29:40 uploaded 6d after created	no	Dropbox · History
Hearing Date Received for Lurinso Tolber 08172023 Tue, 15 Aug 2023 191909 +0000 (UTC).PDF IN THE COUNTY COURT, IN AND FOR BREVARD COUNTY, FLORIDA STATE OF FLORIDA Case Number: 05-2023-MM-0\|3515-AXXX-XX Filed in Open Court on July 20, 2023 9.51 am. M. Kolezynski, Deputy Clerk LURINSO A TOLBER Participant ID Number: 4158223 36789510 NOTICE TO APPEAR FOR PLEA You are hereby notified that th… [show full stored text]	Unclassified	113.2 KB	2023-08-16 11:32:37	no	Dropbox · History
Hearing Date Received for Lurinso Tolber 09142023 Mon, 11 Sep 2023 153415 +0000 (UTC).PDF processed-40B8433F-13C4-4AE5-910D-C3346398AAE6-C4C70258-DD34-4 IN THE COUNTY COURT, IN AND FOR BREVARD COUNTY, FLORIDA STATE OF FLORIDA Case Number: 05-2023-MM-013515-AXXX-XX VS. LURINSO A TOLBER Participant ID Number: 4158223 Filed in Open Court on August 17, 2023 204 pm A Esposito, Deputy Clerk 36… [show full stored text]	Unclassified	110.1 KB	2023-09-25 01:12:49 uploaded 13d after created	no	Dropbox · History
Image.jpeg OTB STATE OF FLORIDA VS. LURINSO A. TOLBER Participant ID Number: 4158223 IN THE COUNTY COURT, IN AND FOR BREVARD COUNTY, FLORIDA Case Number: 05-2023-MM-013515-AXXX-XX Filed in Open Court on June 9, 2023 10:02 am. J Sikes, Deputy Clerk 36609496 NOTICE TO APPEAR FOR DOCKET SOUNDING You are hereby no… [show full stored text]	Image (unclassified)	3.8 MB	2023-07-08 14:09:56	no	Dropbox · History
Tolber, Lurinso A Credit Card Authorization Form copy.pdf Credit Card Authorization form CO Marlon Lavon Elliott , give permission to Axiom Surety Corp dba Bail 2 GO to charge Indemnitor my card for the following transaction(s). My card details will be stored under my Bail 2 GO profile and will only be used for approved transaction(s) and incurred expenses… [show full stored text]	Unclassified	340.2 KB	2023-05-17 12:47:34 uploaded 108d after created	no	Dropbox · History
Tolber, Lurinso A 2 Transfer_Bond_Confirmation (97).pdf AIA Surety Transfer Bond Confirmation Date: To: 1/29/2023 Jessica Fax: Authorization: (866) 425-8119 25b768cc-253277 This fax confirms that your office requested the following transfer bond: Request Date: Defendant: 01/29/2023 Lurinso Tolber County: Brevard Bond Amounts): $500.00 Transfer Bond Fees:… [show full stored text]	Unclassified	56.9 KB	2023-05-17 12:47:34 uploaded 106d after created	no	Dropbox · History
Tolber, Lurinso A address.png ARC Bixby Cénter 9 •Bixby Rd S Hamilton" Make the Team "training center" Blacklick Trail Trailhead Clearwater Lake -London Groveport Rd- Groveport Service Center Ioneer Yard Solutions Groveport Cruiser Park FOUNDERS BEND 9 Cuthbert Greenhouse -WALDEŃ PON Street View Map data ©2023 4388 Landmark Rd G… [show full stored text]	Image (unclassified)	703.8 KB	2023-05-17 12:47:34 uploaded 103d after created	no	Dropbox · History
Tolber, Lurinso A Collateral Receipt.pdf Transaction Receipt 1/29/23, 11:28 AM Print Receipt Merchant: Bail 2 Go Trust 2911 39th ST STE 700 Orlando, FL 32839 US Order Information Description: TOLBER, LURINSO A collateral Order Number: Customer ID: Marlon Lavon Elliott Billing Information Marlon Elliott 4388 Land Mark Rd Groveport, OH 43125… [show full stored text]	Unclassified	55.1 KB	2023-05-17 12:47:34 uploaded 108d after created	no	Dropbox · History
Tolber, Lurinso A File Checklist.pdf Completed File CheckList Folder Named Properly - (Last-Name, First - 10/19/22 - NZ) All Files are named correctly in Folder, - (Doe, John - Booking report etc....) Booking Sheet Mugshot (Current or Previous) TLO's for all parties involved Clerk Search for "ALL" Relevant Counties State ID's for all s… [show full stored text]	Unclassified	68.4 KB	2023-05-17 12:47:34 uploaded 103d after created	no	Dropbox · History
Tolber, Lurinso A Prem & Collateral Receipts.pdf 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- 6312-5914 PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE Bail 2 GO - Orlando P.O. Box 592643,… [show full stored text]	Unclassified	163.7 KB	2023-05-17 12:47:34 uploaded 108d after created	no	Dropbox · History
Tolber, Lurinso A Premium & Transfer Receipt.pdf Transaction Receipt 1/29/23, 11:26 AM Print Receipt Merchant: Bail 2 GO 2911 39TH ST STE 700 ORLANDO, FL 32839 US Order Information Description: Order Number: Customer ID: (407) 254-5554 TOLBER, LURINSO A Premium & Transfer P.O. Number: Marlon Lavon Elliott Invoice Number: 2023-00001278 Billing Info… [show full stored text]	Unclassified	54.6 KB	2023-05-17 12:47:34 uploaded 108d after created	no	Dropbox · History
Tolber, Lurinso A Rapsheet.pdf.pdf 1/29/23, 11:05 AM BCSO - Bookings BCSO - Bookings Back to Search Inmate Details - TOLBER, LURINSO A Demographic Information Name: TOLBER, LURINSO A Subject Number: 5013603 Date of Birth: 11/07/1992 Age: 30 Gender: Male Race: Black or African American Height: 72 Weight: 320.0 Address 4388 LANDMARK RD… [show full stored text]	Court/case doc	228.9 KB	2023-05-17 12:47:34 uploaded 108d after created	no	Dropbox · History
Tolber, Lurinso A READ ME .pages	Unreadable (unsupported file type -- not a PDF/JPG/PNG) reason: unsupported-filetype	94.3 KB	2023-05-17 12:47:34 uploaded 103d after created	yes	Dropbox · History
Tolber, Lurinso A Screenshot 2023-01-29 at 11.26.16 AM.png SPECUDAUN horize.Net® OME Welc TOOLS REPORTS TRANSACTION SEARCH ninal actions ling ion Suite ormation ervices ater Transaction Confirmation Transaction 43904057299 has been successfully ACCEPTED by the system. Below is a summary: Transaction ID: 43904057299 Payment Method: XXXX0230 Amount: 200.00 Cu… [show full stored text]	Image (unclassified)	158 KB	2023-05-17 12:47:34 uploaded 108d after created	no	Dropbox · History
Tolber, Lurinso A Screenshot 2023-01-29 at 11.28.24 AM.png Transaction Confirmation Transaction 43904057357 has been successfully ACCEPTED by the system. Below is a summary: Transaction ID: 43904057357 Payment Method: XXXX0230 Amount: 500.00 Customer Name: Marlon Elliott View Printable Receipt Enter a New Transaction Note: Please do NOT click the browser's … [show full stored text]	Image (unclassified)	95.6 KB	2023-05-17 12:47:34 uploaded 108d after created	no	Dropbox · History
Tolber, Lurinso A TLOxp - Advanced.pdf TLOxp - Advanced 1/29/23, 11:16 AM Your Current Reference ID: NONE 1 Result Found for people named LURINSO A TOLBER born on 11/07/1992 in the United States. LURINSO A TOLBER , 30 Years Old (Franklin County, OH) LURINSO A TOLBER (12/01/2010 to Possible Relatives 12/03/2022) None found LORENZO A TOLBE… [show full stored text]	Unclassified	72.2 KB	2023-05-17 12:47:34 uploaded 108d after created	no	Dropbox · History
Tolber, Lurinso A Transfer_Bond_Confirmation (97).pdf AIA Surety Transfer Bond Confirmation Date: To: 1/29/2023 Jessica Fax: Authorization: (866) 425-8119 25b768cc-253277 This fax confirms that your office requested the following transfer bond: Request Date: Defendant: 01/29/2023 Lurinso Tolber County: Brevard Bond Amounts): $500.00 Transfer Bond Fees:… [show full stored text]	Unclassified	56.9 KB	2023-05-17 12:47:34 uploaded 108d after created	no	Dropbox · History
Tolber, Lurinso A - Bail Bond Agreement Indemnitor (JB) - signed.pdf 1/29/23, 11:05 AM BCSO - Bookings BCSO - Bookings Back to Search Inmate Details - TOLBER, LURINSO A Demographic Information Name: TOLBER, LURINSO A Subject Number: 5013603 Date of Birth: 11/07/1992 Age: 30 Gender: Male Race: Black or African American Height: 72 Weight: 320.0 Address 4388 LANDMARK RD… [show full stored text]	Indemnitor app (digital)	1.3 MB	2023-05-17 12:47:34 uploaded 108d after created	no	Dropbox · History
Tolber, Lurinso A Brevard Clerks.pdf 2/3/23, 8:55 AM Name Display BECA - Brevard Electronic Court Application Logged in as: Public Log Out Name Search - LURINSO% TOLBER Case Number 05-2023-MM- 013515-AXXX- XX Count 1 Party Name TOLBER LURINSO A Party Type DEFENDANT (1) Charge Date 01/29/2023 BATTERY Case Title STATE VS TOLBER LURINSO A… [show full stored text]	Court/case doc	97.3 KB	2023-05-17 12:47:34 uploaded 103d after created	no	Dropbox · History
Tolber, Lurinso A BV EDP.pdf a allegheny CASUALTY COMPANY PO Box 5600, Thousand Oaks, CA 91359 800.935.2245 info@aiasurety.com THIS IS A 4-PAGE, DOUBLE SIDED DOCUMENT READ CAREFULLY AND COMPLETE BAIL BOND APPLICATION - DEFENDANT PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE: Bail 2 GO - Orlando P.O. Box 592643, Orlando, FL 32859 (407) 254-5554 Defendant Name Lurinso A Tolber Home Phone Number My friends / family know me as Cell Phone Number Work Phone Number (614) 316-1911 Current Full Address, City, State and Zip 4388 LANDMARK RD, GROVEPORT, FL OHIO From To Landlord Name (if applicable) Email lorenzo_elliot@yahoo.com • Own • Rent Landlord Phone Number tion Former Full Address, City, State and Zip 9 From To Landlord Name (if applicable) • Own • Rent Landlord Phone Number • M • F Height Birth Date 11/07/1992 Weight Birth Place Social Security Number 272-96-4298 Eye Color Tattoos / Piercings Hair Color Glasses Facial Hair Scars / Distinguishing Marks Medical Conditions / Disabilities Years in City Years in State Former City Driver's License / ID Number TN733793 Former State U.S. citizen? Alien Number •Yes No State Issued OH How long in US? Arrest Date Booking Name (if different) Booking Number 2023-00001278 Arresting Agency Court Name Judicial District Jail Location Brevard County Jail Complex County State Case Number Appearance Date Time Battery - Touch or Strike • Provous rest Cages 1 Provous Are 2 Changes Probation / Parole Officer Name Arrest date Arrest Location Arrest date Arrest Location Phone Number Pending Charges in Other Counties Bonded before by On parole/probation? Currently on bond? Previously failed to appear? • Yes • No • Yes • No • Yes •I No When Co-Defendant Name Co-Defendant Phone Number Form# ACC.0301 (11/22) Page 1 of 4 Print Form Reset Form Current Employer Position Supervisor's Name Position Union Military Branch • Single Significant Other Name • Married Cohabitating Significant Other Current Full Address, City, State and Zip Home Phone Number Cell Phone Number I same one are em Former Significant Other Name Former Significant Other Current Full Address, City, State and Zip Home Phone Number Cell Phone Number Facebook Username Twitter Username Linkedin Username i Password Password Password Year Make Model Color i marn many Insurance Company / Agent Financial Institution • Separated DOB DOB Form# ACC.0301 (11/22) Page 2 of 4 Phone Number Phone Number Local Number Active • Yes • No • Divorced DOB Email Social Security Number Phone Number Phone Number DOB Email Social Security Number Other Account Password Plate Number Balance owed Phone Number Phone number Average Balance How Long How Long Discharge Date • Widowed Years together Years together Username State • Savings • Checking Print Form Reset Form Reference Name Full Address, City, State and Zip Reference Name Full Address, City, State and Zip Reference Name Full Address, City, State and Zip Reference Name Full Address, City, State and Zip Reference Name Full Address, City, State and Zip DOB Cell Phone Number DOB Cell Phone Number DOB Cell Phone Number DOB Cell Phone Number DOB Cell Phone Number Relationship to Defendant Work Phone Number Relationship to Defendant Work Phone Number Relationship to Defendant Work Phone Number Relationship to Defendant Work Phone Number Relationship to Defendant Work Phone Number I hereby represent that the foregoing information is true, complete and correct and is made for the purpose of inducing Allegheny Casualty Company to issue, or cause to be issued, bail bond(s) for the defendant referred to herein. Signed, sealed and delivered this Authorized Signatures Defendant Signature Defendant Print Name Lurinso A Tolber Driver's License Number TN733793 Social Security Number 272-96-4298 Birth Date 11/07/1992 SEE NEXT PAGE FOR APPLICABLE FRAUD WARNINGS. Form# ACC.0301 (11/22) Page 3 of 4 Print Form Reset Form IMPORT A FRAUD WARNIN ALABAMA RESIDENTS Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or who knowingly presents false information in an application for insurance is guilty of a crime and may be subject to restitution fines or confinement in prison, or any combination thereof. ARKANSAS RESIDENTS Any person who knowingly presents a talse or traudulent claim tor pavment tor a loss or benetit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. CALIFORNIA RESIDENTS For your protection California law requires the following to appear on this form: Any person who knowingly presents false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison. FLORIDA RESIDENTS Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree. LOUISIANA AND MAINE RESIDENTS It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties may include imprisonment, fines or a denial of insurance benefits. MARYLAND RESIDENTS: Any person who knowingly or willfully presents a false or fraudulent claim for payment of a loss or benefit or who knowingly or willfully presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. NEW JERSEY RESIDENTS Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties. NEW MEXICO RESIDENTS Any person who knowingly presents a false or fraudulent claim for payment or a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to civil fines and criminal penalties. NEW YORK RESIDENTS Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime, and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation. OHIO RESIDENTS Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an applicatior or files a claim containing a false or deceptive statement is guilty of insurance fraud OKLAHOMA RESIDENTS WARNING: Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes any claim for the proceeds of an insurance policy containing any false, incomplete or misleading information is guilty of a felony PENNSYLVANIA RESIDENTS RHODE ISLAND, TENNESSEE, VIRGINIA, WASHINGTON, AND WEST VIRGINIA RESIDENTS defrauding the company. Pendits say nolde imprisonment, tines or a denial of insurance benefiny for the purpose of Form# ACC.0301 (11/22) Page 4 of 4 Print Form Reset Form allegheny CASUALTY COMPANY PO Box 5600, Thousand Oaks, CA 91359 800.935.2245 info@aiasurety.com THIS IS A DOUBLE SIDED DOCUMENT READ ALL SIDES CAREFULLY BAIL BOND AGREEMENT (" Agreement") PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE: Bail 2 GO - Orlando P.O. Box 592643, Orlando, FL 32859 (407) 254-5554 Agreement Details 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: 01/30/2023 Lurinso A Tolber Indemnitor Name(s) Lurinso Tolber, Marlon Elliot Total Bond Amount $ 500.00 Total Premium $ 100.00 Power Numbers) N/A ("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 Indemnitor Signature Print Name Lurinso A Tolber Print Name Indemnitor Signature Indemnitor Signature Print Name Print Name Indemnitor Signature Indemnitor Signature Print Name Print Name Si no puede leer ni entender Inglés, favor de marcar este cuadro. Check box and complete the following if translation is required Translation Certification. The undersigned translator makes this affidavit and hereby certifies, under penalty of perjury, that he/she read verbatim and translated this entire document, including the reverse side, and all related bond application documents including disclosures, promissory notes, security instruments and trust deeds, to the Indemnitor signing below in his/her primary language. Translator Print Name Translator Signature Translator Full Address Date Confirmo por mi colocación de mis iniciales que las dos caras de este acuerdo han sido traducidos completamente a mi satisfacción. (I confirm by my affixing my initials that this contract has been translated to my satisfaction.) INDEMNITOR Initials Form# ACC.FL.0307 (10/21) READ ALL TERMS AND CONDITIONS ON THE FRONT AND BACK OF EACH PAGE Page 1 of 4 Print Form Reset Form And Conditi 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. Defendant 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. 3. Surety shall have control and jurisdiction over the Defendant during the term for which the Bond is in effect and shall have the right to apprehend, arrest and surrender the Defendant to the proper officials at any time as provided by law and/or this Agreement. It the Detendant is surrendered betore a tailure to appear in Court, and for a reason other thar as stated in paragraph 4, you may be entitled to a retund of the Bond premium it required by applicable law it 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 your obligations o 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 suretv b Detendant moves trom nis/ner current address without prior written consent of the surety, or Detendant Tall: o notify Surety of any changes in address; (c) Defendant commits any act that constitutes reasonable evidence of the intention to cause a torteiture of the Bond or Detendant's tailure to appear in Court as required: (d Detendant is arrested and incarcerated for any other oftense (other than a minor traffic violation); (e) Detendant or an Indemnitor makes any materially talse statement in any material submitted to surety tor the Bond cludina the Bail Bond Application and Indemnitor Application; (f The bail for Defendant is increased; g ndemnitor requests the surrender to custody of the Defendant; and/or (h) There is a material increase in th 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 Defendant to custody is required for any reason, including the failure to appear by Defendant at any required Court proceeding or hearing, Defendant understands, agrees, and acknowledges that such apprehension and surrender involves risk of harm to Defendant 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, losses yany a pass agains Surely ling all agents neployees there arsing or or rea 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, or 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 tortelture ot, or ludament on, the Bond, plus any related court costs, interest anc aal tees incurred; (b any tugitive recoverv tee it there is a torteiture of the Bond (which tee is tvpically ten to twenty percent [10-20%] of the amount of the Bond plus any out of pocket expenses); (c) any and all costs incurred to extradite and/or apprehend and return Defendant to custody; and/or (d) if a collection action is required 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 any action against you as to the propriety of such payment and as to the extent of your liability to Surety for such payment hereunder. Further, you will, upon demand, place with Surety the requisite cash funds to meet any Liabilities (including a pending unpaid judgment or forfeiture demand), whether the demand is made before or after Surety has paid or advanced such funds. . Subiect to applicable law it anv). anv collateral (real or personal. includina cash or securities) pledaed to or depositec with Suretv as security for the obliaations under this Agreement ("Collateral of any and all sums due to Surety for any and all Liabilities sustained, paid or incurred by Surety. You authorize the or any part thereof, in order to pay or reimburse the Suretv for any and all the Bond and/or to place the Suretv in cash funds so as to protect the Suretv against the payment of any Liabilities, including any claim, demand, loss, or judgment arising out of the Bond, even if the Suretv has not paid any such Liability. Subiect to applicable law (if anv). the Suretv mav make any such sale, at its discretion, at public or private sales, and without demand, notice or advertisement of the time and place of said sale. anc 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 satisfactory Collateral so that the total value of the Collateral shall equal the value of the Collateral at the time of the initial pledae or deposit. Subject to applicable law (if any), if you fail to deposit such additional Collateral, the Surety shall have the full right, power and authority, without further demand or notice, to sell, assign and deliver the whole or any part of such Collateral, including any substituted or additional Collateral, at public or private sale, at its option, and without demand, notice or advertisement, and also with the right to purchase said Collateral at any such sale, freed and discharged from any equity or redemption as provided by applicable law. 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 Print Form Reset Form Terms And Conditions (continued from previous page) whether or not the Surety is entitled to be indemnified at the time of the entry, recording or filing of such COJ. If 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 remedv. 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 trom 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 and deliver to Surety a legal release of claims upon the return by Surety of the Collateral to you. † the Surety deems it necessary to make any outlay to protect any Collateral or security in its possession, whether for real or personal property, you authorize the Surety to do so, and you agree to indemnify and reimburse the Surety for 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 for 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 consent from you. Subject to any limitations imposed upon Assignee by the Surety, Assignee shall have the right to enforce in any suit, foreclosure, action, proceeding or otherwise any of the right of the Surety herein or arising out of any of the transactions contemplated hereby, and you shall not, and expressly waive any right to, assert the claim or defense 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, Reporting Act) and any local or state law relating to Surety obtaining, and you consent to and authorize Surety to obtain, any and all private or public intormation and/or records concerning you trom any party or agency, private or governmental (local, state or federal), including, but not limited to, credit reports, Social Security Records, criminal cIvil records, driving records, tax records, records, medical records, school records, worker or governmental (odal, state or federal contacted by surety to turns to Surely or Bail Producer, in accordance wate 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 Defendant 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 the il Compilance by belondant win the flowing terms and conting in period, and the Bond contined upon (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 information as required by Court Order or process; (e) Surety, including its agents and representatives, will be and (f YOU WILL NOT HAVE THE AND ANY APPLICABLE BOND EMISSION PERIOD KING DURING THE PERIOD THE BOND IS IN FORCE 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 tederal law, then such provisior shall automaticallv be deemed to have been revised to comply with such law so as to provide Suretv with the maximum rotection from any Liabilities. The invalidity or unentorceability ot any provision herein (or portion thereot) shall in n vay 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 agreement between the Surety and you. All statements, representations, promises, agreements, and affirmations made by the Surety or Bail Producer, or any representative, employee or agent, thereof prior to or contemporaneously with the execution of this Agreement are contained within this document, Agreement, are of no force or effect whatsoever in determining the rights, obligations and/or liabilities between the 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 Print Form Reset Form 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 happenina ot anv one of the tollowing events shall constitute a breach c Defendant's obligations to uretv. and suretv shall have the raht to immediate v appreheno. arrest and surrende Defendant, and no person shall have any right to any refund of premium whatsoever. The events which constitute a oreach of Defendant's obligations hereunder are: a) If Defendant departs the jurisdiction of the Court without the written consent of the Court and Surety or Bai Producer; (b) If Defendant moves from one address to another within the State of Florida without notifyin Surety or Bail Producer in writing prior to moving; (c) If Defendant commits any act which constitutes reasonable evidence of Detendant's intention to cause a torteiture of the Bondia It Detendant is arrested and incarcerated for any offense other than a minor traffic violation; or (e) If Defendant makes any material false statement in the Agreement. Division of Consumer Services, Bail Bond Section, 200 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. . For good ana valuable consideration, vou agree to indemnıty Supplemental Terms etendant as a condition ot the bono and lo the ball Producer's and suretv's powers relatino to the cancellation of tr 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 filing of motions; (c) Documented transportation and lodging expenses outside the jurisdiction of the court; (d) for housing, re-arrest, transportation and extradition; and (e) A maximum fee of $100 for a surrender allowed by law when there has seen no torteiture ot 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. 0. Suretv shall be entitled to deduct trom collatera held or anv return premium all tees. expenses. ano charde uthorized bv applicable law. includina Florida Administrative Code 69B-221.105 a conflict between the terms and conditions of the Agreement and this Supplement, this Supplement shall control. Form# ACC.FL.0307 (10/21) Page 4 of 4 Print Form Reset Form 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 P.O. Box 592643, Orlando, FL 32859 (407) 254-5554 Defendant Name Lurinso A Tolber Power Number(s) N/A Case Number As principal (defendant) and/or indemnitor (guarantor) on a bail bond, you must be given a copy of any collateral documents that you sign relating to the above bond(s). When all agreements have been fulfilled, bond is discharged in writing by the court, and without loss expense on the bond(s), your collateral will be returned to you. BE AWARE: YOUR COLLATERAL IS AT RISK if the principal fails to appear in court or if the principal commits any breach (violation) of agreement. ANY OF THE FOLLOWING HAPPENINGS IS A BREACH OF AGREEMENT: 1. If principal fails to appear in court; 2. If principal shall depart the jurisdiction of the court without the written consent of the court and the Surety, or its agent; 3. If principal shall move from one address to another without notifying the Surety, or its Agent, in writing, prior to said move; 4. If principal shall commit any act which shall constitute reasonable evidence of principal's intention to cause a forfeiture of the bond (s); 5. If principal is arrested and incarcerated for any offence other than a minor traffic violation; 6. If principal shall make any material false statement in the application; 7. If principal shall violate any special restriction or condition of the bond(s) imposed by the Court. For general information regarding your collateral, contact the agency as shown on the top of this sheet. 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 ** I/We have received a copy of this information sheet. I/e have received a copy of all collateral documents that I/We signed regarding the above bond(s). Defendant Signature Indemnitor Signature Print Name Date Date Signed original to agent's bond file; Copy to defendant and each indemnitor Form# ACC.FL.0028 (10/22) Page 1 of 1 Print Form Reset Form allegheny CASUALTY COMPANY PO Box 5600, Thousand Oaks, CA 91359 800.935.2245 info@aiasurety.com PRIVACY NOTICE PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE: Bail 2 GO - Orlando P.O. Box 592643, Orlando, FL 32859 (407) 254-5554 This Privacy Notice applies to your non-public personal information (personal information") received by Allegheny Casualty Company and/or AlA Holdings, Inc., as applicable, ("Surety"), through that 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: THE INFORMATION WE COLLECT: The Bail Producer is a licensed, independent contractor who is appointed by us to write bail. Prior to issuing a bail bond, the Bail Producer will collect, and in some cases, transmit to us your personal information. Your personal information is obtained from a variety of sources: • Applications and other forms (e.g., name, address, social security number, employment information, family member information, assets, income, and property locations and values) and electronically if you use our website or web-based date - our website uses cookies to collect individual information about you and your website usage); • Transactions and experiences with us and others, (e.g., credit card and account balances, and payment history); and • Consumer reporting agencies, medical providers, or others (e.g., credit score, background checks, and medical and employment information). HOW WE USE & PROTECT PERSONAL INFORMATION: Your personal information will be used to process the bail bond application, underwrite and post the bond and resolve bond claims or breaches of contract. We may provide your personal information to others working with us who need this information for these purposes, such as attorneys and investigators. Your personal information is used to assess the risk of the bail bond transaction, protect against fraud, or generally to effect, administer or enforce the terms of the bail bond transaction. Only authorized personnel are permitted to access your personal information. We convey to our employees and appointed Bail Producers the need to protect your personal information and require our outside vendors and service providers to keep your personal information confidential and to use it only to provide the services we have asked them to perform. PARTIES TO WHOM WE MAY DISCLOSE INFORMATION: We do not disclose your personal information to anyone except as permitted/required by law - for example, to industry regulators, law enforcement agencies, credit bureaus, subpoena, and third parties that assist us in the bail bond process and underwriting. We do not sell your personal information to anyone, and do not share your personal information with any companies or organizations that would use it to contact you about their products and services. CONFIDENTIALITY AND SECURITY: We maintain physical, electronic and procedural safeguards to protect your personal information. We ensure that your personal information is treated responsibly and consistent with our privacy policies. We also restrict access to your personal information within our organization to those persons who must have the information to provide services to you or to conduct our business. Persons who have access to your personal information may use it only for our business purposes. We safeguard your personal information in accordance with applicable laws. You have a right to review your personal information and to request that we correct, amend or delete such information on file. WEB PRIVACY: When you visit AlA's website at (www.aiasurety.com), the Web server automatically collects and maintains statistical information from our site's data logs that concern network traffic flow and volume. The information that is collected does not identify personal information. The collected information is used to improve the usefulness of the web site. We reserve the right to change this Privacy Notice at any time. The most up to date version of our Privacy Notice can be found on AIA's website. CALIFORNIA CONSUMER PRIVACY ACT: For California Residents, please visit www.aiasurety.com/CCPA to access our complete California privacy statement under the CCPA. If you would like a full copy of the policy, please contact the Surety at (818) 223-3308 or privacy@aiasurety.com. FURTHER INFORMATION: If you have any questions about how we use the information we collect, please write to us at: AIA Compliance Department, PO Box 5600, Thousand Oaks, CA 91359. Indemnitor / Defendant Signature [Indemnitor / Defendant Printed Name Date Lurinso A Tolber Form# ACC.0027 (10/21) •g4 Page 1 of 1 Print Form Reset Form 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- SOC202301311245 PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE Bail 2 GO - Orlando P.O. Box 592643, Orlando, FL 32859 (407) 254-5554 Date Received 01/30/2023 Payer Name Lurinso A Tolber Defendant Lurinso A Tolber Power Number(s) N/A Court Payment Method • Cash Check • Credit Card • Money Order Credit Card Authorization Code Amount Received ($) N/A Payer Phone Number (614) 316-1911 Bond Amount $) 500.00 Appearance Date Itemized Expense(s) (if and as permitted by applicable law) Transfer/Posting Fee Case Numbers) Appearance Time Expense Amount $ 100.00 $ $ $ 08185 Form# ACC.0304-1 (10/21) Payer Signature Print Name Lurinso A Tolber Collateral Received Collateral Receipt Numbers) • Yes • No 6312-8717, 6312-8719 Bail Bond Premium $ 100.00 ° Total Expense(s) $ 100.00 Prior Payments) ($200.00 Amount Received ($ N/A Remaining Balance $ 0.00 Producer/Representative Signature Producer/Representative Print Name ) PREMIUM RECEIPT and STATEMENT OF CHARGES I understand that the premium owing or paid is fully earned upon the Defendant's release from custody, and the fact that the Defendant may have been improperly arrested, re-arrested, the case dismissed, or the bail reduced shall not obligate the return or forgiveness of any portion of the premium except as otherwise provided by applicable law (if any) as stated in the Bail Bond Agreement. COLLATERAL RECEIPT allegheny CASUALTY COMPANY PO Box 5600, Thousand Oaks, CA 91359 800.935.2245 info@aiasurety.com Receipt No.: ACFL- 6312-8719 PRODUCER NAME, ADDRESS, PHONE, EMAIL AND PRODUCER LICENSE NUMBER MUST BE PREPRINTED OR STAMPED HERE: Bail 2 GO - Orlando P.O. Box 592643, Orlando, FL 32859 (407) 254-5554 Type • Deposit of collateral: Depositor hereby acknowledges receipt of • Return of collateral: Depositor hereby surrenders the original and acknowledge a copy of this document and agrees to the terms on the reverse he return and receipt of collateral listed herein and that the collateral has bee side. The collateral identified below is deposited as security for the bail bond(s), premium owed, if any, and all lawful expenses Ties bai produce from any luther lability or responsibily i relation the or tara. incurred due to underwriting the referenced bail bond(s). Returning collateral from receipt numbers) Date Received 01/29/2023 Depositor Name(s) Lurinso A Tolber Depositor Address 4388 LANDMARK RD, GROVEPORT, FL OHIO Power Number(s) N/A Depositor Phone Number (614) 316-1911 Defendant Name Lurinso A Tolber Case Number Item (s) Received - describe below, specify condition Promissory Note, Signature Bail Bond Agreement Funds - in form of • Cash • Check If applicable, I acknowledge a Credit Card fee of Signature • Money Order Bond Amount 500.00 Amount or Estimated Value Held By $ 500.00 • Bail Producer Surety $ Bail Producer Surety 7 Credit Card $ Bail Producer Surety % in the amount of $ Signature FLORIDA USE ONLY Form# ACC.FL.0304-2 (10/22) Print Name Lurinso A Tolber Print Name Jessica Bolden 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 alien 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. CONTINGENT PROMISSORY NOTE nis Contingent Promissorv Note ("Note) is beina executed bv the undersianed "Maker') to secure Alleahenv Casualt ompany, as surety, upon tortelture or estreature or the surety bond s) posted on benalt or detendan Lurinso A Tolber ("Defendant"). On demands after date, for value received, I/We promise to pay to the order of Allegheny Casualty Company the sum of $ 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) COUNTY, FLORIDA PIA number(s) N/A Signature Lurinso A Tolber Maker Name Form# ACC.FL.0036 (10/21) Signature Date Maker Name Date 08212 Print Form Reset Form	Defendant app (digital)	475.8 KB	2023-05-17 12:47:34 uploaded 107d after created	no	Dropbox · History
Tolber, Lurinso A CR.png « Collateral Request Form 2023 Defendant's First and Last Name? Lurinso Tolber Date We Posted Bail? 01/29/2023 Copy of Collateral Receipt collateral Receipt.pdf Indemnitor's First and Last Name? Marlon Elliott Photo of Indemnitor's State ID or Gov ID Marlon Elliott ID Card.pdf Indemnitor's Address ?… [show full stored text]	Image (unclassified)	160.3 KB	2024-07-06 23:39:52	no	Dropbox · History
Tolber, Lurinso A TLOxp - Advanced Indem.pdf TLOxp - Advanced 1/29/23, 11:50 AM Your Current Reference ID: NONE No subjects were found using your search criteria. However, we have expanded your search and were able to locate the subjects) below using similar criteria. Showing the 1 Result Found for people named MARLON L ELLIOT located in GROVE… [show full stored text]	Unclassified	93 KB	2023-05-17 12:47:34 uploaded 108d after created	no	Dropbox · History

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Tolber, Lurinso A 1:29:23 - JB

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