SUPERSEDEAS BOND Case No. _______________________ I / we _______________________________________________________________________________, principal, and I / we______________________________________________________________________________ , surety, bind ourselves to _______________________________________________________________________________ in the penal sum of ______________________________________dollars. To be void on condition that the said________________________________________________________________ shall prosecute, with effect, writs of Certiorari and Supersedeas in the CHANCERY COURT of SHELBY COUNTY TENNESSEE, Part ______, from a judgment for ____________________________________dollars and ________ cents and costs of suit rendered against __________________________________________________ by _______________________________ in and for said County, on the _______ day of ________________________, 20____ in favor of the said _______________________________________________________________________ or shall abide by and perform the judgment of the Court, and in any event shall pay all such costs as may at any time be judged against the said ________________________________________________________________________ WITNESS our hands and seal the ___________ day of ________________________________, 20______ Firm _________________________________________ by_________________________________________ ________________________________________ _________________________________________________, security on the above bond, being sworn, says that he/she owns in his/her own name the right, above all debt and encumbrances, the following real estate to, to wit _____________________________________________________________________________________________ _____________________________________________________________________________________________ and personal property to wit ______________________________________________________________________ and that said property is situated within Shelby County and the State of Tennessee and is subject to execution. Sworn to and Subscribed before me, this ______ day of ________________________, 20 ____ Donna L. Russell, Clerk & Master By_______________________________, D.C.M Form 00-10/06 American LegalNet, Inc. www.FormsWorkFlow.com