IN THE CHANCERY COURT OF HAMILTON COUNTY, TENNESSEE ________________________________________ vs. ________________________________________ * * * * * * N0.______________ PART________ BOND FOR STAY & COSTS ON APPEAL Pursuant to Rule 62.05, Tennessee Rules of Civil Procedure, the undersigned agree, recite, and declare that: Whereas in the above styled action________________________________________________________________ ________________________________________________________________________________________[Appellant(s)] have prayed an appeal from one or more decrees of this COURT, said decree(s) having been entered on: ________________________________________________________________________________________[Date(s)]; and Whereas said Appellant(s), desiring to perfect said appeal, hereby with their Surety execute this bond conditioned to secure the payment in this action of costs and of the judgment, pursuant to Rule 62.05, Tennessee Rules of Civil Procedure, if the appeal is finally dismissed or the judgment affirmed or the payment of such costs as the court may direct if judgment is modified.; and Whereas ______________________________________________________________________________[Surety] of ___________________________________________________________________________________[Surety's Address] agrees to stand as surety for the costs and of the judgment, pursuant to Rule 62.05, Tennessee Rules of Civil Procedure; NOW, THEREFORE, in consideration of the above recitals, the undersigned covenant and agree as follows: 1. OBLIGATION. We jointly and severally bind ourselves, our heirs, executors and administrators, firmly by these presents unto the CLERK & MASTER and unto the COURT OF APPEALS for the payment of costs in this appeal, and further in the sum of $__________________ unto ___________________________________________________________ _________________________________________________________________________________________[Appellee(s)] to secure the payment of the judgment in full, interest, damages for delay; and/or to secure obedience of the judgment and payment for the use, occupancy, detention and damages or waste of the property from the time of appeal until delivery of possession of the property. 2. THE CONDITION OF THIS OBLIGATION. Should the Appellant(s) well and truly and with effect prosecute said appeal, and abide by and perform all orders and decrees of this COURT or the COURT OF APPEALS, then the above obligation will be void, otherwise to be and remain in full force and effect. IN WITNESS WHEREOF, executed on this _______ day of __________________, 20____. ___________________________________ ___________________________________ Principal Surety ___________________________________ ___________________________________ Social Security Number Federal Employer Identification Number Page 1 of 1. BOND FOR STAY & COSTS ON APPEAL Form 012, Rev. 2006.05.02 American LegalNet, Inc. www.FormsWorkflow.com