IN THE CHANCERY COURT FOR THE STATE OF TENNESSEE 20TH JUDICIAL DISTRI CT, DAVIDSON COUNTY _______________________ ) ) P laintiff, ) ) vs. ) No. ____________ ) _______________________ ) ) Defendant. ) MOTION TO PROCEED IN FORMA PAUPERIS ON APPEAL Comes now the (plaintiff/defendant), ______________________ acting in and for (his/her) own proper person, and moves this Court to allow (him/her) to proceed in forma pauperis on appeal. Respectfully Submitted, __________________________ Plaintiff/Defendant __________________________ __________________________ A ddress Certificate of Service I hereby certify that a true and correct copy of the foregoing document was sent via first class prepaid mail upon the following parties on this the ______ day of _____________, 20__.