NOTICE OF VIOLATION OF THE TERMS OF THE COURT’S ORDER FOR ELECTRONIC MONITORING BY THE DEFENDANT AND AFFIDAVIT

Date of Order

In the Court Of:

Court & Case Information

Court Issuing Bond:

Docket/Case Number*

Date of Bond*

Amount of Bond*

County*

Defendant Information

Name (First and Last)*

Address*

Street Address Address Line 2 City State ZIP Code

Violation(s) Detail

THE ABOVE-REFERENCED DEFENDANT HAS VIOLATEDTHE CONDITIONS OF THE BAIL ORDER (INCLUDLING ELECTRONIC MONITORING) AND THE BONDREFERENCED ABOVE AS FOLLOWS:*

Specify the "Other" Violation

Cite the facts surrounding the violation of the Order. Attach additional sheets, if necessary and any electronic monitoring report.

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Attached to this report are copies of the following documents related to the violation of the court’s order:

A copy of the court’s order.

An executed copy of the monitoring agreement.

A copy of the monitoring report showing a violation of the court’s order.

Witness affidavit or other photographic or documentary evidence as to unauthorized contact with the victim, possession of drug or alcohol use, possession of weapons and ammunition, violation of the law, etc.

A copy of the written notice(s) or emails to the Defendant that he has failed to timely pay the full monthly electronic monitoring fee and the cost of the monitoring services.

Affidavit from an authorized representative of the electronic monitoring company setting forth the specific facts related to the violation of the court’s order.

Date of Violation

Bail Bondsman Information

Name (First and Last)*

Title

Agent's Email*

Agent's Phone*

Bail Bondsman Address

Street Address Address Line 2 City State ZIP Code

Submitter Signature

Bench Warrant Request*

I hereby request the issuance of a bench warrant in accordance with the provisions of §§ 38-53-50 and 38-53- 70.

Name

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