TENNESSEE COURTS UNIFORM FACSIMILE FILING COVER SHEET TO: Davidson County Chancery Court Clerk CLERK'S FAX NUMBER: 862-5722 CASE NAME: _____________________________________________________ DOCKET NUMBER: ______________________________________________ TITLE OF DOCUMENT: __________________________________________ FROM (SENDER): ________________________________________________ SENDER'S ADDRESS: ____________________________________________ SENDER'S VOICE TELEPHONE NUMBER: ______________________ SENDER'S FAX TELEPHONE NUMBER: _________________________ DATE: __________________________________ TOTAL PAGES, INCLUDING COVER PAGE: _____________________ ******************************************************************************** CONFIRMATION (For Clerk's office use only) □ This confirms your facsimile filing listed above was processed by ___________with the filing date of __________________________. Your service charge pursuant to T.R.C.P. 5A.04 is $______________ Please send your payment along with this cover sheet within 10 days to: Clerk & Master's Office 1 Public Square, Suite 308 Nashville, TN 37201 DENIED FOR FILING Your facsimile listed above WAS NOT FILED OR PROCESSED due to the following deficiency: □ The facsimile filing was longer than 10 pages and not pre-approved by the Court. □ The document you attempted to file by facsimile transmission is prohibited from filing in this manner by T.R.C.P. 5A.02 (4) American LegalNet, Inc. www.FormsWorkFlow.com