Form No. 10 United States Bankruptcy Court Western District of Tennessee In re: Bankruptcy Case No. Debtor Chapter Plaintiff Adversary Proceeding No. Defendant SUMMONS AND NOTICE OF PRETRIAL CONFERENCE IN AN ADVERSARY PROCEEDING TO: Name of Defendant to be Served: YOU ARE SUMMONED and required to submit a motion or answer to the complaint which is attached to this summons to the clerk of the bankruptcy court within 30 days after the date of issuance of this summons, except that the United States and its offices and agencies shall submit a motion or answer to the complaint within 35 days. Address of Clerk At the same time, you must also serve a copy of the motion or answer upon the plaintiff’s attorney. Name and Address of Plaintiff’s Attorney If you make a motion, your time to answer is governed by Fed. R. Bankr. P. 7012. YOU ARE NOTIFIED that a pretrial conference of the proceeding commenced by the filing of the complaint will be held at the following time and place. Address Room Date and Time IF YOU FAIL TO RESPOND TO THIS SUMMONS, YOUR FAILURE WILL BE DEEMED TO BE YOUR CONSENT TO ENTRY OF A JUDGMENT BY THE BANKRUPTCY COURT AND JUDGMENT BY DEFAULT MAY BE TAKEN AGAINST YOU FOR THE RELIEF DEMANDED IN THE COMPLAINT. Jed G. Weintraub Clerk of the Bankruptcy Court By: American LegalNet, Inc. www.FormsWorkFlow.com Form No. 10 (pg. 2) CERTIFICATE OF SERVICE I, _________________________________________, certify that I am, and at all times during the service of process (name) was, not less than 18 years of age and not a party to the matter concerning which service of process was made. I further certify that the service of this summons and a copy of the complaint was made _________________ by: (date) Mail service: Regular, first class United States mail, postage fully pre-paid, addressed to: Personal Service: By leaving the process with defendant or with an officer or agent of defendant at: Residence Service: By leaving the process with the following adult at: Publication: The defendant was served as follows: [Describe briefly] State Law: The defendant was served pursuant to the laws of the State of _______________________, as (name of state) follows: [Describe briefly] Under penalty of perjury, I declare that the foregoing is true and correct. date signature Print Name Business Address City State Zip American LegalNet, Inc. www.FormsWorkFlow.com