STATEMENT OF SURRENDER
THE UNDERSIGNED SURETY/BAIL BOND PRODUCER on behalf of ______________________________wishes to surrender/recommit the defendant and hereby authorizes ______________________________as a licensed bail bond producer, licensed agent of the surety, or any law enforcement officer having jurisdiction to take the defendant, _____________________________, into custody and deliver and surrender the defendant or cause the defendant to be surrendered/recommitted into the custody of the ________________________ in the City/Parish of ______________________________, State of ________________.
The lawful reason for the surrender/recommit is:
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Dated this _______________day of ___________________, 20___________.
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Surety/Bail Bond Producer/Agent of Surety or Bail Bond Producer
La. R.S. § 22:1585
Former R.S. 22:1585 redesignated as R.S. 22:347 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.