National Bonding Co

Group 5


Payment Agreement

Download or fill out the form below


PAYMENT TERMS: I (We) having obtained a surety bond release for:


and having an unpaid balance hereby agree to Afford-A-Bail Bonds Bondsman:

A surety bail bond agent may enter into a premium financing arrangement with a defendant or any co-signer( s) in which such agent extends credit to such defendant or co-signer(s ). If a surety bail bond agent enters into a premium financing arrangement, such agent shall require (1) the defendant on the bail bond or any co-signer( s) to make a minimum down payment of thirty five percent of the premium due, and (2) the defendant and any co-signer( s) to execute a promissory note for the balance of the premium due. Such promissory note shall provide that such balance shall be paid not later than fifteen months after the date of the execution of the bail bond. In the event that payments against the premium become 60 days delinquent, or if such balance has not been paid in full to the surety bail bond agent by the due date, National Bonds CO. reserves the right to revoke bail and the agent shall file a civil action seeking appropriate relief with the court.

This note is due and payable as follows:

MM slash DD slash YYYY
basis thereafter until the
is paid in full
Pursuant to Connecticut General Statue Section 36a-660c, all outstanding balances may be paid IN FULL no later than 15 months after the execution of this bond. If the principal or indemnitor on this note is more than sixty days in arrears, all outstanding balances must be paid IN FULL immediately. Pursuant to Connecticut General Statue Section 36a-660c, If payment due under this note is more than sixty days in arrears regardless of outcome of case, this agent must file a civil action seeking appropriate relief with the court. No Exceptions. May be collected jointly or individually.

FORMS OF PAYMENT: Check, credit card or money order may be accepted. Some fees apply.

Verification of Current or Previous Employment and/or compensation for:
I authorize National Bonds CO. on behalf of my employer to release information relative to my employment.
I authorize the release of the following information (Please check one):
Employment Agreement(Required)

If l (We) do not fulfill our obligation as set forth above, National Bonds CO. may transfer, sell or dispose of any and all security in any manner they may deem necessary to pay any unpaid balance . I (We) understand the value of any security is determined by the amount National Bonds CO. can expeditiously obtain from immediate transfer of same. I (We) further agree to remit to National Bonds CO. immediately upon demand any deficiency balance there may be by transfer of same. I (We) also understand I (We) are responsible for any and all costs incurred as a result of such transfer. I (We) agree that any security deposited may be held or transferred to indemnify National Bonds CO. for any balance owed or that may become owed to them under the bail bonds agreement. I (We) understand I (We) are responsible for any storage fees incurred for the security deposited.

ATTORNEY'S FEES: If this note is given to an attorney for collection or enforcement, or if suit is brought for collection or enforcement, or if it is collected or enforced through probate, bankruptcy, or other judicial proceeding then payer(s) shall pay National Bonds CO., all costs of collection and enforcement, including reasonable Attorney's fees and court costs in addition to other amounts due.

MM slash DD slash YYYY
By signing I agree to pay any cost that may be incurred for late payments.
For monthly invoice check box

Payer #1


Employment Information

Employer Address

Mail payments to: National Bonds CO. 1 Hartford Square Suite 654, New Britain, CT 06052

Any questions regarding payments please call: 860-792-4267