In consideration of the release of __________________ (name of person charged) charged with __________________ (name or description of offense) it is agreed that the aforementioned prisoner will be restrained at the __________________ (appropriate military installation) in whatever degree considered to be appropriate by his commanding officer. This restraint will be for a minimum of 12 hours in all cases involving consumption of alcoholic beverages. It is further agreed that he will not be transferred, granted leave, or discharged from the __________________ (appropriate service) without notice to the sheriff or his deputy and will be delivered to the sheriff or his deputy upon demand. These terms and conditions will be withdrawn only upon his posting of the required personal bond or upon the release by the sheriff, his deputy, or the appropriate court.
Signed __________________
Official title __________________
OCGA § 17-6-3