NE EXEAT REPUBLICA BOND Docket No. ______________________ I/we __________________________________________________________as principal and __________________________________________________________________ as surety, acknowledge ourselves obligated to pay into Court, the sum of $ __________________ dollars, in the event __________________________________________, plaintiff/defendant, violates the conditions of this bond as set forth below. The condition of the above Bond is such, that __________________________________, plaintiff/defendant, filed a Complaint in the Chancery Court of Shelby County, Tennessee against ________________________________ plaintiff/defendant and obtained an order for the issuance of a Ne Exeat Republica which restrained ____________________________________, plaintiff/defendant, from leaving the jurisdiction of this Court, and further that the plaintiff/defendant should be remanded to the custody of the Shelby County sheriff until he/she posts bond in the amount of $ _________________ dollars; said bond to remain in full force and effect until further orders of the Court. Witness our hands and seals this _____ day of ________________, 20 _____. ____________________________________ ____________________________________ ____________________________________ ____________________________________ Form B0-05/04 American LegalNet, Inc. www.USCourtForms.com