Elementor #16 – National Pretrial Signup

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Step 1 of 7 - UNIT DETAILS

Unit Number*

Unit Type

Ordered By:*

Customer ID

CLIENT INFORMATION

Client Name*

Date of Birth*

Height*

Weight*

Tattoos?*

Race*

Sex*

Hair Color*

Eye Color*

Client Home Address*

Street Address Address Line 2 City State ZIP Code

Client Cell Phone*

Client SSN*

Client Email*

Employer*

Employer Phone*

Employer Address*

Street Address Address Line 2 City State ZIP Code

CHARGES, RESTRICTIONS AND APPOINTMENTS

The client listed above is mandated to wear a GPS Monitor as per the designated order, based on the charges specified, and must adhere to the following restrictions and appointments.

Charge #1*

Power#1*

Restriction #1

Appointment #1

Charge #2

Power#2

Restriction #2

Appointment #2

Charge #3

Power#3

Restriction #3

Appointment #3

Criteria for Violations

Failure to comply with any of the above agreements will result in the revocation of our monitoring. Any of the following actions will result in a violation:

If your monitor reaches 40% battery, you will receive a phone call. If you fail to charge your monitor and it reaches 20%, an agent will retrieve your monitor, and you will be in violation.
If you are on house arrest and leave your zone, you will be in violation.
If you do not call the agent/agency to notify them of any scheduled events at least 24 hours before
the event, you will be in violation.

GPS Monitoring Services Agreement

By signing below, I, the undersigned client, hereby acknowledge, agree, and enter into an agreement with National Pretrial and its designated agency for GPS monitoring services under the terms set forth herein.

Monitoring and Compliance

I consent to be monitored 24/7 by National Pretrial as a condition of my bond if ordered by the Court, Surety Company, or Bondsman acting on behalf of the referenced agencies.
I understand the importance of charging my monitor for 2 hours every 24 hours to ensure continuous operation.
I acknowledge that I must remain within the geographic zone ordered by the court, surety, or agency.

Financial Obligations

I am responsible for all costs associated with the monitoring services until they are formally concluded by a court order.
If I fail to make payment arrangements with National Pretrial’s collections staff before the 6th day of each month, a late fee not exceeding 10% of my total due balance will be added to the current month’s invoice. All non-monthly billing arrangements require a signed and current credit card authorization form on file with National Pretrial.
Failure to meet these financial obligations will result in a bond violation and subsequent legal consequences.

Equipment Care and Liability

I agree not to destroy, tamper with, or remove the GPS monitor from my leg, except in emergencies or with prior written permission.
In the event of damage or unauthorized removal of the monitor, I will be liable for the device's total cost, not to exceed $1,200. Criminal charges including but not limited to escape, theft over $500, and vandalism may be pursued by National Pretrial based on evidence of tampering.
Upon installation, I agree not to hold National Pretrial liable for any personal injuries or damages related to the use of the monitor.

Information Handling

If I request information regarding my case, including location reports and personal data, I consent to this information being shared with the agencies listed above.

Consent and Rights

I affirm that I am signing this agreement voluntarily, without coercion, and acknowledge that this monitoring does not violate my civil rights.
I agree to indemnify and hold harmless the service provider, installer, and manufacturer from any claims related to the device, including attorney fees, costs, and injuries arising from the manufacturer's defects.

Electronic Transactions

By signing this document, I consent to conduct business electronically, which includes signing documents and receiving notices electronically.
I can request paper copies of any electronic document. I may withdraw my consent to electronic communication by notifying National Pretrial in writing.

Client Acknowledgement*

I AGREE

Client (Defendant) Signature

Date

FAMILY / FRIENDS AS PERSONAL REFERENCES

Reference Name #1*

Reference Name #2*

Reference Address #1

Street Address Address Line 2 City State ZIP Code

Reference Address #2

Street Address Address Line 2 City State ZIP Code

Reference Phone #1*

Reference Phone #2*

Reference #1 Relationship*

Reference #2 Relationship*

CO-SIGNER INFORMATION

Co-Signer Name*

Co-Signer SSN*

Co-Signer Date of Birth*

Co-Signer Home Address*

Street Address Address Line 2 City State ZIP Code

Co-Signer Sex*

Co-Signer Relationship*

Co-Signer Cell*

Co-Signer Email*

Co-Signer Driver's License*

Co-Signer License Plate*

Co-Signer Employer*

Co-Signer Employer Phone*

Co-Signer Work Address*

Street Address Address Line 2 City State ZIP Code

Co-Signer Work Supervisor*

Co-Signer How Long?*

Working at this Employer

Co-Signer Supervisor*

Department

GPS Monitoring Fee Payment Agreement

By signing below, I hereby affirm and agree to the following:

1. I acknowledge the full responsibility of paying the aforementioned client's selected GPS monitoring fee hereunder.
2. I agree to pay the GPS monitoring fee on behalf of the Client if the client fails to make the payment or defaults on their payment obligations under this agreement.
3. This obligation shall remain in effect until the client has fully complied with the payment terms set forth in the primary contract or until this obligation is terminated in writing by mutual consent of all parties involved.
4. In the event of my nonpayment or default, I understand that appropriate legal actions may be taken to recover any unpaid fees. I shall be responsible for any legal costs incurred during such actions, which will be under the laws of the state of South Carolina.

Co-Signer Acknowledgement*

I AGREE

Co-Signer Signature*

Date

PRETRIAL AGENT INFORMATION

Bail Bonds Agency*

Agent Phone*

State*

County*

Bail Agent Name*

Bail Agent Email*

Install Agent Name*

Install Agent Email*

Liable Agent Name*

Liable Agent Email*

Acknowledgment and Affirmation by National Pretrial Agent

Agent Representation I, the undersigned, as an authorized agent of National Pretrial, hereby certify and affirm that the information contained within this GPS Installation Packet is accurate and correct, representing faithfully the details as provided.

Responsibilities Post-Installation

Best Interests: Upon successful installation of the referenced GPS monitoring device, I commit to acting in the best interests of all involved parties.
Alert Management: I will diligently receive and appropriately respond to all alerts, notifications, and violations that may arise while the client is under monitoring.

Financial Obligations

Payment Collections: I further acknowledge my responsibility to ensure that all payment collections associated with this account are maintained current and up to date.

National Pretrial Agent Acknowledgement*

I AGREE

National Pretrial Agent Signature*

Date

Authorizing IP

RECURRING PAYMENT AUTHORIZATION

Recurring Credit Card Payment Authorization

By signing this form, you give us permission to debit your account for the amount indicated below on or after the indicated date. This is permission for recurring transaction(s) to be debited from the below credit card.

Card Holder Name*

Card Number*

Expiration Date*

CVV*

Billing Address*

Same and Client Home Address?

Street Address Address Line 2 City State ZIP Code

Recurring Subscription*

Recurring Amount

GPS UNIT INSTALLATION PAYMENT

Subscription Plan*

Paid By:*

Installation Fee

Price:

Total Amount:

Total Amount Paid Today

Coupon Code

Cash Receipt Upload*

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Upload Court Order*

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Cash Payment Terms*

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Credit Card*

All Services provided by National Pretrial Technology and Services LLC, hereinafter National Pretrial

I authorize National Pretrial to charge the credit card specified below for the amount indicated on or after the specified date. This authorization applies to the initial installation charge and the facilitation of recurring transactions per the subscription plan selected above for ongoing monitoring services, per the agreed schedule detailed below, ensuring uninterrupted service and convenience. By signing this form, I confirm that I am the authorized user of the credit card entered and have the authority to approve this transaction. I further agree not to dispute the charged amount with my credit card company so long as the transaction corresponds to the terms described in this authorization. This payment authorization is valid for the transaction of goods/services described, for the stated amount, and under the specified billing subscription plan schedule.

Client Payment Authorization*

I AGREE