Bukit Bail Fund Intake form
If you or someone you care about needs help paying bond in Allegheny County, please complete the form below.
Sign in to Google to save your progress. Learn more
Email address
Your Name *
Your phone number *
The full legal name of the person who needs to be bailed out *
The name of the jail where the individual is being detained
Emergency contact number? *
If you are the individual's lawyer, please include a family member or friend's contact number (or, if not, please include your client's number). If there is no additional phone number, enter 999-999-9999.
What is the bail amount?
If you are unsure what the amount is, you can call Allegheny County Court Records at 412-350-2183 to ask.
Does this person consent to being bailed out?
Clear selection
Person's date of birth (if you know it)
MM
/
DD
/
YYYY
Do you know if this individual is currently on probation or parole? *
Is this person subject to any holds or detainers (for example, probation, parole, or immigration)?
If you are unsure whether they are, you can call Allegheny County Court Records at 412-350-2183 to ask.
Clear selection
Do you know their docket number(s)? Please include all cases, if there are multiple.
Does this individual have any medical issues that we should be aware of?
Any other information you have that would be helpful?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy