Tuscaloosa Bail Out Referral Form
Your Name *
Your Phone Number *
Your Email Address
Full Legal Name of Person in Need of Bail *
Name of Jail Detained
Date of Arrest
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DD
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Bail Amount *
Has the judge in this person's case approved the payment of 10% of their bond in lieu of the full amount? *
Does this person consent to being bailed out with our assistance?
Clear selection
Does this person have any attorney or public defender? If so, please list their name and any contact information you have. *
Person's Date of Birth
MM
/
DD
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Is this person currently on probation or parole?
Clear selection
Is this person subject to any holds or detainers (for example, probation, parole, immigration, warrants)?
Clear selection
Will this person need a ride? If not, who will we need to contact to ensure they are there when we post bail. *
Is this person experiencing homelessness? If so, is there a specific location we should return them to? If where they will stay is unknown, let us know and we will try our best to coordinate/ find resources for them.
Once released, will this person have access to a phone?
Clear selection
If they have access to a phone or are provided with one, would they like to have court reminders?
Clear selection
Does this person speak English? If not, please list their language.
Once released, will this person prefer referrals to any local resources (mental health, food banks, career, childcare) or food assistance? If yes, please describe.
Does this person have any medical issues we should be aware of?
Is there any other information we should know about this person?
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