Kan. Stat. § 12-4304
An appearance bond shall be deemed sufficient if it states substantially as follows:
Appearance Bond. In the Municipal Court of __________, Kansas. The City of __________ vs. ______________, the accused person, as principal, and ______________, as surety, (where surety is used) acknowledge ourselves to be indebted to the City of __________, Kansas, in the sum of ______________ Dollars, secured as required by law, upon these conditions:
That said accused person shall personally appear before the Municipal Court of __________, Kansas, on the ____ day of __________, 19__, at __________ o'clock a.m. and, if an appeal is taken, shall appear in the District Court of the county in which the city is located, and from time to time as required by the court to answer to the complaint, according to his or her promise to do so, which the accused person hereby makes then this bond shall be void; otherwise it shall remain in force.
Dated this ____ day of __________, 19__.
_______________________________
(Accused Person)
_______________________________
(Address)
________________________________
(Surety) (Where Applicable)
_________________________________
(Address)
Receipt for cash surety
Received from ______________, accused person, ______________ Dollars cash security on above bond this ____ day of __________, 19__.
_____________________________________________________
(Clerk of Municipal Court or Law Enforcement Officer)
OR
Receipt for guaranteed arrest bond certificate security
Received from ______________ a guaranteed certificate issued by ______________, as security on above bond this ____ day of __________, 19__.
______________________________________________________
(Clerk of Municipal Court or Law Enforcement Officer)
OR
Receipt for operator's license security
Received from __________, accused person, operator's license issued by the state of __________, bearing number __________, issued to said accused person, as security on above bond this ____ day of __________, 19__.
_____________________________________________________
(Clerk of Municipal Court or Law Enforcement Officer)
OR
Approval of surety
Surety approved this ____ day of __________, 19__.
_____________________________________________
(Municipal Judge)
OR
Bond without surety
This bond approved without surety.
_____________________________________________
(Municipal Judge or Law Enforcement Officer)
K.S.A. 12-4304