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PLC:

a004td

Agency:

menominee indian tribe

For:

court fines & fees

Phone:

715-799-5104

Address:

w2908 tribal office loop road
keshena, wisconsin 54135

*Required Field

Payment Information

If the Cardholder is present to sign the bond, they acknowledge.

*Do you intend to sign the bond as the surety? If so, you MUST appear in person at the Detention Center. You may receive funds back if the defendant meets all court requirements. If you do not sign as the surety, funds will be returned to the defendant.:

If the Cardholder is not present to sign the bond, they acknowledge

*The cardholder acknowledges that he/she relinquishes any claim to these funds and understands and agrees that these funds will become the property of the defendant.:

*Furthermore, the cardholder understands that upon disposition of the charges/cases against the defendant, any funds ordered returned by the court will be returned to the defendant and not the cardholder.:

*Check Yes if you understand the Verbiage above:

Yes

Notices above come from the Broomfield Police Detention Center

*Defendant Name:

Middle:

*Last:

*Date of Birth:

(Month / Day / Year)

Notes:

Payment Amount

Payment Information :

Subtotal:

$0.00

Total:

$0.00

Billing Information

*First Name:

Middle Initial:

*Last Name:

*Billing Address:

*City:

*State/Province:

*Zip:

*Country:

*Phone Number:

*Credit/Debit Card:

(enter the full card number without any dashes or spaces)

*Expiration Date:

*Card Security Number:

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