Ky. R. Crim. P. Form 11
As amended through March 4, 2024
( RCr 4.34 )
(Caption)
The affiant says that he resides in __________________ County, __________________, (State) and owns in his own right the following property:
Location
Description (County and state) Value
1. $
2. $
There are no encumbrances against except as follows:
Name and address of lienholder or claimant Amount of lien or claim
1. $
2. $
The affiant is not obligated on any other bonds or undertakings for bail except as follows:
Name of principal Court in which taken Amount
1. $
2. $
__________________
(Surety)
Subscribed and sworn to before me at ______, this ______ day of ______, 19______.
__________________
(Signature)
__________________
(Title)
Ky. R. Crim. P. Form 11