STATE OF TENNESSEE, COUNTY OF To Any Lawful Officer To Execute and Return: Summon each Defendant to appear before the Judge of the General Sessions Court of Madison County, on , 20. To be held in the General Sessions Court Room, on the 3rd Floor of the Criminal Justice Complex, at 515 South Liberty Street, Madison County, Jackson, Tennessee to answer the claim by Plaintiff(s) for a money judgment for rent, damages, attorney fees, and court costs and for possession of property Plaintiff claims that Defendant(s) wrongfully possesses in this county having a street address, or otherwise described as:. Defendant222s initial possession was based on a written oral lease or and the right to possession has now terminated because of non-payment of rent or . Written Oral notice to vacate was given to Defendant(s) on or about , 20. Rent payments of $ are due on the day of each , and the amount of rent owing through and unpaid is $. Plaintiff holds $ paid as a damage/security deposit. Plaintiff asks for possession of the property, all unpaid rent owed as of the court date, restitution for damages to the property, attorney fees (if provided for in the contract), and all court costs and litigation taxes. Issued Clerk/Deputy Clerk Judgment for against for $ and possession plus interest at the rate of % and cost of suit, for which execution may issue. Judgment entered by: Default Agreement Trial Dismissed: Without Prejudice With Prejudice Costs Taxed to: Plaintiff Defendant Defendants(s) in court and admitted to jurisdiction of court. This the day of , 20. , Judge Division White Copy 226 Original Canary Copy 226 Plaintiff Pink Copy - Defendant Case No. Plaintiff Address City State Zip Phone vs. Defendant Address City State Zip Defendant Address City State Zip DETAINER SUMMONS Court of Madison County General Sessions Kathy Blount, Clerk By , Deputy Clerk Issued , 20. Set for at . Reset for Served Upon All Named Defendants All Defendants Except: Served , 20. Sheriff/Constable (Process Server) Attorney for Plaintiff Telephone Attorney for Defendant Telephone DETAINER SUMMONS JUDGMEN T SERVICE American LegalNet, Inc. www.FormsWorkFlow.com This the day of , 20. Judge 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 Notary Public My Commission Exp. TO THE DEFENDANT(S): Failure to appear and answer this Summons will result in judgment by default being rendered against you for the relief requested. Tennessee law provides a four thousand dollar ($4000) personal property and five thousand dollar ($5000) homestead exemption from execution or seizure to satisfy a judgment. If a judgment should be entered against you in this action and you with 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 items include items of necessary wearing apparel (clothing) for yourself and your family and trunks and 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 not understand your exemption right of how to execute it, you may wish to seek the counsel of a lawyer. Legal Authority: TCA 24729-18-112 AFFIDAVIT ORDER American LegalNet, Inc. www.FormsWorkFlow.com