APPEAL BOND FOR COSTS I (we), I (we), for the costs of appeal in: , principal(s)/ Appellant(s), and , the surety(ies)/ Attorney, bind myself/ourselves vs. Cause No. , PRINCIPAL/APPELLANT (Signature) or by PRINCIPAL (Print) PRINCIPAL'S ADDRESS: ATTORNEY (Signature) PRINCIPAL(S) SOCIAL SECURITY NO.: PRINCIPAL(S) DRIVER'S LICENSE NO.: (street address only; NO P.O. boxes; NO in care of principal's attorney) (Social Security/Driver's License Numbers Required for individual principal(s) per T.C.A. § 25-1-108) by SURETY (Print) (Signature) Note: If you are signing as surety on behalf of a law firm, please print the name of the firm on the space provided. If you are signing as an individual surety, please print your name. If you sign as an individual surety, you are personally responsible for the costs should the principal fail to pay. SURETY'S ADDRESS: (street address only; NO P.O. boxes) IF THE PRINCIPAL(S) PAY ALL COSTS OF APPEAL, THEN THIS OBLIGATION IS VOID. IF PRINCIPAL(S) FAIL(S) TO PAY, THEN THE SURETY IS OBLIGATED TO PAY ALL COSTS OF APPEAL. *IF YOU DO NOT HAVE A SURETY TO SIGN YOUR BOND FOR COSTS *: A cash deposit of $1,000.00 is deemed sufficient instead of a surety bond, except as otherwise required by the trial court clerk and/or the Appellate Court Clerk. deposit of $ with the day of A in cash has been made by of the , . court clerk's office on APPROVED: or CLERK OF THE TRIAL COURT Rev: 8-11-2008 CLERK OF THE APPELLATE COURT American LegalNet, Inc. www.FormsWorkFlow.com