Miss. Code § 99-5-1
Bail may be taken in the following form, viz:
"State of Mississippi,
____________________ County.
We ____________________, principal, and ____________________ and ____________________, sureties, agree to pay the State of Mississippi ____________________ Dollars, unless the said ____________________ shall appear at the next term of the Circuit Court of ____________________ County, and there remain from day to day and term to term until discharged by law, to answer a charge of ____________________.
Signed ____________________
____________________
Approved ____________________
____________________ "
When the bail is for appearance before any committing court or a judge, the form may be varied to suit the condition.
When a bond is taken from a professional bail agent, the following must be preprinted or stamped clearly and legibly on the bond form: full name of the professional bail agent, Department of Insurance license number, full and correct legal address of the professional bail agent and complete phone number of the professional bail agent. In addition, if the bond is posted by a limited surety professional bail agent, the name of the insurer, the legal address of the insurer on file with the department and phone number of the insurer must be preprinted or stamped, and a true and correct copy of an individual's power of attorney authorizing the agent to post such bond shall be attached.
If the bond is taken from a soliciting bail agent, the full name of the soliciting bail agent and the license number of such agent must be preprinted or stamped clearly and legibly along with all information required for a professional bail agent and a true and correct copy of an individual's power of attorney authorizing such soliciting bail agent to sign the name of the professional bail agent.
Any professional bail agent and/or soliciting bail agents who issue a bail bond that does not contain this required information may have their license suspended up to six (6) months and/or be fined not more than One Thousand Dollars ($1,000.00) for the first offense, may have their license suspended up to one (1) year and/or be fined not more than Five Thousand Dollars ($5,000.00) for the second offense and shall have their license permanently revoked if they commit a third offense.
The court or the clerk of the court shall notify the department when any professional bail agent or soliciting bail agent or insurer issues a bail bond that contains information that misleads a court about the proper delivery by personal service or certified mail of a writ of scire facias, judgment nisi or final judgment.
Miss. Code § 99-5-1