GPS Install Application

Responsible Party Information

The person completing this section must be the one responsible for payment and signing the agreement,

not the person who will wear the GPS device.

Payor / Guarantor

First Name *

Last Name *

Phone *

Secondary Phone

Email *

Preferred Language *

Address *

Street Address

City

State

Country

Postal Code

Upload your Driver License *

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Payor / Guarantor (Employment)

Employer Name *

Job Title *

Length of Employment *

Employer Phone *

Monthly Income *

Pay Frequency *

Monitored Individual (MI) Info & Location

Full Name (Monitored Individual) *

Mobile Number (Monitored Individual) *

What Jail or facility (County/State) monitored individual located? *

Who is requiring the GPS monitoring? *

County Service Needed (Place Monitored Individual will be monitored) *

Conditions of Release *

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Bondsman & Conditions of Release

Complete this section if a bondsman will be posting the bond for release.

Missing information may delay approval or release.

Bondsman Name

Bondsman Email

Bondsman Mobile Phone

Will Monitored Individual be on house arrest? *

Will Monitored Individual be on a curfew? *

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from My GPS Monitor, LLC.