N.Y. Comp. Codes R. & Regs. tit. 11, § 28.17
(a) Premium and collateral paid. Every bail agent shall issue a numbered receipt to each indemnitor on a form promulgated by the superintendent for all premiums paid to the bail agent and for all collateral pledged with the bail agent in connection with an indemnity agreement or bail agreement upon collecting the premium or collateral from the indemnitor. The bail agent shall issue a receipt to each indemnitor when there is more than one indemnitor. Each such receipt shall include, at a minimum, the:
(b) Premium and collateral returned. Every bail agent shall issue a numbered receipt to each indemnitor on a form promulgated by the superintendent for all premiums and collateral returned to each indemnitor. The number on the receipt shall be the same number as the corresponding receipt required by subdivision (a) of this section. The bail agent shall issue a receipt to each indemnitor when there is more than one indemnitor. Each such receipt shall include, at a minimum, the:
(d) The bail agent shall provide, as set forth in section 28.18 of this Part, to the principal and each indemnitor, as applicable:
(2) the following written statements on a form promulgated by the superintendent: