STATE OF TENNESSEE SHELBY COUNTY CHANCERY COURT DOCKET NUMBER REPLEVY BOND PLAINTIFF(S) DEFENDANT(S) BOND AMOUNT (TCA 29-6-149) DATE BOND EXECUTED I/We __________________________________________________________________________principal, and __________________________________________________________________________________ surety, acknowledge ourselves indebted to ________________________________________________________________ in the sum of $ ______________ dollars; plaintiff has filed a complaint in the Chancery Court of Shelby County, Tennessee, praying an attachment therein against the estate of the said Defendant described as: _______________ __________________________________________________________________________________________ __________________________________________________________________________________________ ____________________________________________________________________________________________. The amount of the claim is $ _______________ dollars and in the event Plaintiff recovers a final judgment against the Defendant and said judgment is not paid by the Defendant together with all interest and costs, then this Replevy Bond shall stand as security for the payment of the Plaintiff’s judgment, interest and costs. Upon execution of this Bond together with proper surety, the Plaintiff’s attachment against the above described property is released. If the Complaint is dismissed, then this obligation shall be void, otherwise to remain in full force and effect. PRINCIPAL (Name, Address, Signature) SURETY (Name, Address, Signature) _________________________________________ ____________________________________________ _________________________________________ ____________________________________________ _________________________________________ ____________________________________________ _________________________________________ ____________________________________________ Witness our hands and seals this ____ day of ___________________, 20 ____. ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ Form B0-05/04 American LegalNet, Inc. www.USCourtForms.com