IN THE CIRCUIT COURT OF DAVIDSON COUNTY, TENNESSEE TWENTIETH JUDICIAL DISTRICT, STATE OF TENNESSEE } } } } } } } Plaintiff(s) vs. Docket No. Defendant(s) COST BOND I/We, as Principal(s), and as Surety, are held and firmly bound unto the Circuit Court Clerk of Davidson County, Tennessee, for the payment of all costs The Principal(s) is/are commencing legal proceedings in the Circuit Court for the Twentieth Judicial District, at Nashville, Tennessee. If the Principal(s) shall pay all costs which are adjudged against them, then this obligation is void. If the Mandated at Principal(s) fail(s) to pay, then the Surety shall undertake to pay all costs adjudged against the Principal(s). T.C.A. §20-12-120, et seq. PRINCIPAL(S): PRINCIPAL PRINCIPAL Address Employer Address Employer Employer's Address Employer's Address Principal Principal (signature), or by Attorney (signature) Principal Principal (signature), or by Attorney (signature) SURETY (Print or Type Surety) BPR # SIGNATURE OF SURETY ADDRESS [Rev. 7-1-07] American LegalNet, Inc. www.FormsWorkFlow.com Print Form