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• • t • : tet~ ~~>wze ~~~ck~>G~>Ae • 6320 N. RUCKBR RD., P. O. BOX 20112 4 84562 INDIANAPOLIS, INDIANA 46220 Ns. 20161? COLLATBRAL SBCURITY~~R~BC~B~IPT AND AGREBMBNT~ ~ • Bond No.~ ~'~~3- A-mount of Bond Sly-"~s~--Bxocution Date-_i_!=LZ-=~-~--- c YrincipaL_-_ ~L~-~? - ~ - - - - Naane arW e+ese • ~ ~ Owner of Security ~ Name Addretee IMPORTANT! This security will be returned wrhen all cases secured by this collateral have been disposed of. No ~ exchange of collateral will be made. The owner must bring this receipt and a Certificate of Dispositic~n• and also proper ieientifie:ation at time of oolladeral ~ • release. - Thc owner may receive the released collateral via mail by forwarding this receipt, a Certificate of Dispositions a»d a written request to the above address. All cash deposits returnable by check only. No checks shall be cashed or authorized for cash by this company. •NOTE: The court Certificate of Daspo~ition may be obtained from the clerk bf the appropriate Gaut. if this security pertains to more than one case; a certificate mint be obtained for each case. DESCRIPTION OF COLLA'13;RAL: l~o~' 1 A~ud ~~st- ~S• ~Et Qi for 9--~ -alcz~ l) SA6a~ f~•~~ Sv~~v~s~rV ,q.c.Go~~iNq ~ t~,2 ~eRs:o~ ~i~~•e~~~/ i~u 7~~• ~~~ooK ~i~4 L l~o~ 6~ ~a ~'Pubf~SG ~ R~coRcla of /~.u~i ~ C~ev~~t , ~a~~dA . ~ ~ 6~ -7t ~ - OOOt-- coca/i ~l?c ,4 5°'~ ~ et b N ~.:.~a t vs.~ ANA Rr~wo~,v~ z s Fit k:t~ns~tF •n,e~ d Fs~~ I s q a~ ~tN1 ALL ho~us; s~,d gN~ ~x6M~. +'~q~t~--s hE`N~N ~ w~ o~ of o~l~ 5dia7t ©R of t~ un~ i t- Sh+ 1f-sG S~ ~ S ~ , ' a u Rtc~ ~ i ~ /1~'F rR ~ ~ o~t~"p nT `I'h~. pRoµts~~•`~ IV~~ ~ o1t~c.eC ab~~ .a~~ •?.i BH cjj4~A~ i~~- 1M~'t GC1e u ~ ~~RL~I ~A ~ q AGRBBMBN'IS AND CONDITIONS OF DBP06IT: . Allied Fidelity Insurance Car., (hereinafter called Surety) ae*nowlexlges receipt d the above aetatrity from the party designated above ss Owner. deposited with Strrety for the bextefit . of Surety and its eo-sureties, retawrers. snooeasors sad assigns. far a good eoasad- exation and trader the agexmeats and upon the conditions hereinafter stated. ~~e collateral sexurity is pledged and deposited with Stuexy as security: i (a) Agaimt any and all liability. loss. errata, damages. expenses, pre ~ and at_to~rne_y's~f -arising or incumod in connection with the above captioned bond, ex any other bond, reoognaanee, o~"~ e6~obligstion (all of which, together with any eootiauatiotts and modificattoos tbet-wf, are hereinafter referred to as hereaofore err hereafter exexuted aswmed ~ or pnwrod by Surety at the instance ear rrgnest err on behalf either ~d Owner or of the principal abome mated, in eonoec- e tion with which »ndersigrted is an indemnicot; _ f " (b) Far the payment of all premiums on such bonds; ~ (c) Far the peerformance erf every agt+ertnent (including ooatinuatiom or modtfiptions thered, with or without ooetsent d Owner) ~ made by Owns or by any of the prinapaLs in ooooextion with said bonds; ~ (d) Against any liability. loss, ce>dts, expenses and attorney's fees in connection with any claim to the collateral seecurity by peyseas e;Jaiming adversely to owner. To accomplish the purposes d sock deposit, Surety is authorized, at any time and withotu notice or legal process, to rase said eoi- ~ lateral sexurrty. and to apply the same to-payment of or reimbursement for losses, costs or damages. expertsa. attorneyr's tens, preataiums or liabilities as tt may elect: and at its option and is its sole diacretioo, to sell any of said oollataal security at public ear pnvate sale to itself or to any other person, or to depoart, invest, convert, cash, exchange, resew e>r dispose d said oollataal seam- { ity or the proceeds thereof in any manner, io such form sad on wch tee as it deems proper. The rights gives to Sure:tY under this agoeme:nt alaall be in addition to, and not in limitation of, any other rights which Surety may have, tnctoding rights under any- separate agerments. • Owner re:pteroents himsel) to be the sole owner of said ex.Wtera! security, and ogees to save Surety haratless from any loss, costs, espe~ses ear attorney's fees arising from claims to any part thereof by any persons claiming adversely to Owner. If the collateral security shall. by reason of depreciation below its market value u of the time: of deposit, became ieasuJ6Ciaat for Surety's protection, Owner shall, upon demand, deposit additional collateral sexurity. satisfattory to Surety, d a value at least ~ eequal to the amount of such depreciation. Surety shall not be liable for any loss or deepraiation of the collateral security or the proooeds thexeaf, or damage the:ew. udess 8 caused by gross negligence of Surety's o6loera ex employers. Surety shall pay m interest on the collateral seavity, and in the: case d any certificate of depost_'t or any other instruutent evidencing the deposit of money with any person, brat ear corporation incluJed in the collateral security, a is understood that Owner has seleetod the depository, and assumes full responsibility for the safety d the deposited funds. ~ Upon receipt of wrictca evidence satisfactory to Surety d its discharge from all liability tender such bonds, and d ownership d • the collateral sextrrity by the applicant (it being recognized that differeaea d opinion with regard to proof d orrneYShip, and d - termination d liability, require the giving d considerable latitude to Surety in the dexexmanation eaf what evidence is reasanabkj, and d payment d all amounts due as provded herein, Surety shall, within a rrasooabk time, return said collateral security or the pro- E cards thereof, less any deductions pursuant to the terms of this agrameat, to the party then designated as Owner. NEITHER THiS RECEIPT OR THE SECURITY REFERRED TO HEREIN IS TRANSFERABLE OR ASSIGNABLE WITHOUT THE WR[IT@I CONSENT OF A DULY AUTHORIZED OFFICER OF THE SURETY. ~ j~} Datedat_-~~-s~ The toms hereof arc hereb}~ ageed to anti accepted: / 3 this-- f-~ -WY d- - 1')/ ALLIED FIDELfiY INSURANCE CO. - - - Owner{s} gv Autt?orized Representative - - - - ! RECEIVED thi. day from the ALLIE~ FIDELITY INSURANCE CO.. the securities etc.. described in this ageemrnt. Witnessed: ` ~~~-el~~ - - - - - - AFC-32 ~ Sn~'S COY