fill out this form to request bail assistance

YOUR Name *

First Name

Last Name

YOUR Phone Number *

(###)

###

####

YOUR Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are you able to assist with greeting/transportation after bail is posted?

Yes

No

Other (describe in "Other Comments")

PERSON NEEDING BAIL Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Arrest

(if known)

MM

DD

YYYY

Did the arrest occur in Durham County? *

Please note that currently, the NCCBF only operates in Durham County.

Yes