Receipt, Collateral: Passport (E.D. Tex., Dkt. 14, filed 12/12/24)

Summary

Filed 12/12/24 in Case 6:24-cr-00125-JCB-JDL, the form has spaces for the name and address of the person surrendering collateral, a passport number, any other item, and the signature and date of the Deputy Clerk acknowledging receipt. A second section records the return or disposition of the collateral, and the form asks that a copy be retained as proof of surrender.

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Full text

Case 6:24-cr-00125-JCB-JDL             Document 14               Filed 12/12/24         Page 1 of 1 PageID #:
                                               45
                                                   Origin l


                              UNITED STATES DISTRICT COURT I'n .. i r.'
                                         FOR THE
                                 EASTERN DISTRICT OF TEXAS



   United States of America vs.
   Case                                                       No.



   Received on the behalf of the United States from:
   Name:

   Address:


   Collateral:
                 Passport No. / ? 3 S
                 Name:

                 Address:




                 Other:


   Surrendered by                                             Receipt is hereby acknowledged by
   Signatures Date:                                           Signature & Date:


                                                              Deputy Clerk, UsDistrict Court

   Return or Disposition:

                 The collateral above was returned to the original individual on .


                 Signature                                           Deputy Clerk Signature


                 Disposition was made on the collateral above to:
                 (attach proof of disposition documentation to this receipt):




                 Deputy Clerk Signature and Date
                         Please retain a copy of this receipt for proof of surrender.


File and source

File

14.pdf

Size

60,885 bytes

SHA-256

c9eef996b7f1ec60b1ab926dde8d6b9b94f049931ffff3b847f5e973d11f4931

Our copy

14.pdf

Original

No public link identified.