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Name:
Email Address:
What is your address?
What is your phone number?
What is the name and D.O.B of the person in jail?
Where was the person in jail?
How much was the bail?
Name of Bail Agency?
Name of Bail Agent? (
Address of Bail Agency?
Phone number of bail agency?
What is your purpose or reason for writing this message?
What is this complaint regarding?
In your own words, what is the subject of your comments?
Please write your message.


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