State of Tennessee, County of Knox DOCKET NO.DT JUDGMENT To any Lawful Officer to Execute and Return: It is hereby ordered and adjudged: Plaintiff VS Whereas, complaint is made to me by: That plaintiff be restored to the possession of Plaintiff the within described property, for which a Writ who resides at: of Possession may issue, pursuant to the law and whose phone number is: Defendant(s) and address for service court costs are adjudged against the defendant. of a certain forcible and unlawful detainer by: DETAINER WARRANT Defendant Court of General Sessions That plaintiff be restored to the possession of in a certain tract, lot, apartment, house or real estate Clerk: CHARLES D. SUSANO III within described property and a judgment for situated in the County aforesaid and bounded or Issued this day of , 20 $ for which a Writ of known and described as follows: D.C. Possession may issue and court costs are Came to hand same day issued and executed adjudged against the defendant. as commanded on: Dismissed cost to PLTF 226 DEFT Which land the plaintiff alleges it is entitled the POSSESSION of and the defendant unlawfully And citing for trial on: Nonsuit cost to PLTF 226 DEFT detains. We therefore command you to summon the day of, 20, 9:00 A.M. Other defendant to appear before the Court of General Sessions of Knox County, Tennessee, Date Served to be held at the courtroom of said court in DEFAULT The Old Courthouse, 5th Sessions Court Copy of Warrant Posted on Door 300 Main Street, Room 331, Knoxville TN 37902 AGREED Knoxville TN 37902 (P) 865-215-2518 to answer Posted Dates 1 2 3 the complaint and claims for RENT by the Plaintiff Copy of Warrant or Summons mailed via TRIAL in the amount of $ First Class US Mail to the so named plus contractual attorney fees, if any and court costs. defendant at the last known address This day of . 20 INTERLOCUTORY ORDERS (IF ANY) Sheriff/Process Server Judge, Division DAMAGES: Reset Reset DEFAULT AGREED TRIAL Attorney for Pltf This the day of , 20 Judge, Division Attorney for Deft Judge, Division American LegalNet, Inc. www.FormsWorkFlow.com NOTICE TO THE DEFENDANT(S): Tennessee law provides a ten thousand dollar ($10,000.00) personal property exemption from execution or seizure to satisfy a judgment. If a judgment should be entered against you in this action and you wish to claim property as exempt, you must file a written list, under oath, of the items you wish to claim as exempt with the clerk of the court. The list may be filed at any time and may be changed by you thereafter as necessary; however, unless it is filed before the judgment becomes final, it will not be effective as to any execution or garnishment issued prior to the filing of the list. Certain items are automatically exempt by law and do not need to be listed; these include items of necessary wearing apparel (clothing) for yourself and your family and trunks or other receptacles necessary to contain such apparel, family portraits, the family Bible, and school books. Should any of these items be seized, you would have the right to recover them. If you do no understand Your exemption right or how to exercise it, you may wish to seek the counsel of a lawyer. AFFIDAVIT To the best of my information and belief, after investigation of Defendant222s employment, I hereby make affidavit that the Defendant is/is not a member of a military service. ATTORNEY FOR PLAINTIFF OR PLAINTIFF SWORN TO AND SUBSCRIBED BEFORE ME This day of , 20. Notary Public. My term expires: **NOTICE** The American with Disabilities Act prohibits discrimination against any qualified individual with a disability. The Tennessee Judicial Branch does not permit discrimination against any individual on the basis of physical or mental disability in accessing its judicial programs. In accordance with the Americans with Disabilities Act, if necessary, the Tennessee Judicial Branch will provide reasonable modifications in order to access all of its programs, services and activities to qualified individuals with disabilities. If you need assistance, have questions or need additional information, please contact the Local Judicial Program ADA Coordinator: Knox County Human Resources Office City-County Building Suite 400 Main Street, Suite 360 Knoxville, Tennessee 37902 Voice Phone:865-215-2952 TTY:865-215-2497 The Tennessee Judicial Branch Americans with Disabilities Act Regarding Access to Judicial Programs, as Well as a Request for Modification form may be found online at www.tsc.state.tn.us. APPEAL From the judgment on the reverse hereof, the prayed an appeal. To the Circuit Court which is granted upon Pauper222s Oath or Appeal Bond. This day of , 20. Judge of the Court of General Sessions Division No If you require a modification to access the judicial program and/or have special needs because of a qualified disability, you must submit a written Request for Modification to the Local Judicial Program ADA Coordinator listed below at least five (5) business days prior to the date of the judicial program, if possible. A form is available from the Local Judicial Program ADA Coordinator or from the Tennessee Judicial Program ADA Coordinator. http://www.tsc.state.tn.us If you need assistance, have questions or need additional information, you may also contact the Tennessee Judicial Program ADA Coordinator: Pamela Taylor, Manager/Coordinator STATE Judicial ADA Program Administrative Office of the Courts Nashville City Center, Suite 600, 511 Union Street Nashville, Tennessee 37219 615-741-2687 Fax: 615-741-6285 American LegalNet, Inc. www.FormsWorkFlow.com