COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. For Office Use Only Calendar No. AGENT APPOINTMENT BY : JUDICIAL SUBPOENA Plaintiff(s)NONRESIDENT FIDUCIARY 312 Eighth Avenue North -against6th Floor, William R. Snodgrass Building Nashville, TN 37243-0306 : : : APPOINTMENT OF TENNESSEE SECRETARY OF STATE AS AGENT FOR Defendant(s) : . . . . . . . . . . . . . . . . . . . . .SERVICE. OF .PROCESS .FOR NONRESIDENT FIDUCIARY .......... .... ............ .... PURSUANT TO TCA §35-50-107 The undersigned, _______________________________________________, a nonresident perTHE PEOPLE OF THE STATE OF NEW YORK TO son, bank or trust company, wishing to act as a fiduciary in the State of Tennessee in conformity with the laws thereof, hereby appoints the Secretary of State of the State of Tennessee as the undersigned’s agent for service of process. All process in any suit or proceeding against the undersigned may be served upon the Tennessee Secretary of State in any action or proceeding relating to any trust, estate or matter within this State in respect of which excuses being laid aside, acting in a fiduciary capacity. WE COMMAND YOU, that all business and the undersigned is you and each of you attend before GREETINGS: , the Honorable at the Court located at any process against the undersigned, which is served upon the County of The undersigned agrees that in room Tennessee the , on Secretary of State, shall be of at same legal force and validity any if served on the day of , 20 , the o'clock in the noon, and at as recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the undersigned. It is understood that this appointment shall continue for as long as any liability shall remain outstanding against the undersigned pertaining contemptsuch matters. make you liable to Your failure to comply with this subpoena is punishable as a to any of court and will the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of The failure to comply. estate or person for which the undersigned has been appointed as fiduyour specific trust, ciary is: Witness, Honorable Court in County, , one of the Justices of the day of , 20 ________________________________________ ________________________________________ (Attorney must sign above and which all copies of legal proThe street address (including zip code) of the undersigned (to type name below) cess should be addressed) is: Attorney(s) for _________________________________________ _________________________________________ _________________________________________ _________________________________________ Office and P.O. Address Executed this ______ day of _______________________, ______. Telephone No.: Facsimile No.: _____________________________________ E-Mail Address: (signature) Filing Fee $10.00 No.: Mobile Tel. SS-4512 (Rev. 9-01) American LegalNet, Inc. www.USCourtForms.com RDA 1764