Bond Payor Change of Address


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I,                                                                , am the Payor on the receipt of the cash bail bond posted in the above-
styled and numbered cause on behalf of the Defendant listed in the style above.  Such cash bail bond was 
deposited with the Sheriff of Dallas County, Texas, and is to secure the appearance of said Defendant.  The cash 
bail bond is supported by:
RECEIPT NO.: RECPT DATE:
DATE SIGNED:_______________________________  
REV 1/12/12  Digitized 1/12/12
I hereby request that the cash bail bond refund be mailed by the Dallas County District Clerk to the address set 
out below:
PAYOR SIGNATURE
CHANGE OF ADDRESS FORM FOR CASH BAIL BONDS
Payor must present the clerk with a copy of the receipt for the cash bail bond and must also produce a picture 
identification prior to approval of the change of address.
I.D. TYPE:I.D. NO.:
STATE OF TEXAS § IN THE
VS. § DISTRICT COURT           
§ DALLAS COUNTY, TEXAS 
CAUSE NUMBER: 
Business (if applicable):
Street
Home TelefphoneCity
Apt or Unit
ZipState
By: Deputy District Clerk 
 ____________________________________
GARY FITZSIMMONS  
District Clerk, Dallas County, Texas