STATE OF TENNESSEE SHELBY COUNTY CHANCERY COURT DOCKET NUMBER WRIT OF REPLEVIN PLAINTIFF DEFENDANT To the Sheriff of Shelby County-Greetings: You are hereby commanded to take the following goods and chattels described below from the Respondent, (name, address & telephone no.) ____________________________________________ ______________________________________________________________________________________________________ and place in the hands of _________________________________________________________________________________. To wit:_______________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ____ Additional list attached. ____ Attached instructions for the Deputy Sheriff regarding service. This writ of replevin is being issued on behalf of the ____ Plaintiff ____ Defendant. DATE ISSUED Attorney: (Name, address & telephone no.) Donna L. Russell, Clerk and Master 140 Adams Ave. – Room 308 Memphis, TN 38103 By: ________________________________________________________ Deputy Clerk and Master BPR No. _____________________________ RETURN ON SERVICE Came to hand this ____ day of _____________, 20 _____ and 1. ____ Executed on the ____ day of _____________, 20 ____ by removing from the possession of the Respondent _______ _______________________________________, and placing in the possession of _______________________________ _________________________________________________________________________, the above described property. 2. ____ I failed to execute this writ on the Respondent because _________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ Bill Oldham, Sheriff by ___________________________________ Deputy Sheriff Submit two: Original and Copy Form W0-05/04 American LegalNet, Inc. www.FormsWorkFlow.com