STATE OF TENNESSEE To ___________________________________________________________________________ ______________________________________________________________________________ Sheriff of Shelby County ­ Greetings; WHEREAS, ____________________________________________________________ _____________________________________________________________________________ by their petition exhibited and sworn to, obtained from the Honorable ____________________, Chancellor, an order that writs of certiorari and supersedeas issue relative to a certain case wherein ______________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ recovered a judgment against _____________________________________________________ _____________________________________________________________________________ for ______________________ Dollars and __________ cents, and the cost of the suit before the ___________________________________ on the ________ day of _______________, 20 ____ of which said judgment was, as the said petitioner alleges, wrongfully obtained against ________ ______________________________________________________________________________ and ___________ having entered into bond with security, as required by law. You are, therefore, hereby commanded that you desist from proceeding further in the execution of said judgment, and notify the plaintiff that the record in said suit is removed into the Chancery Court to be held for Shelby County, at Memphis to the end that strict justice may then and there be rendered in the premises. Herein fail not, and make due return of this writ. WITNESS Donna L. Russell, Clerk and Master of said Chancery Court in Memphis, Tennessee this _______ day of ____________________, 20 _____. Donna L. Russell, Clerk & Master Form W0-05/04 by ___________________________ D.C. American LegalNet, Inc. www.FormsWorkFlow.com No. _______________________________ CHANCERY COURT Shelby County, Tenn. ______________________________________ Plaintiff vs. { SUPERSEDEAS & CERTIORARI ______________________________________ Defendant Came to hand ____ day of _________, 20____ and __________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ Attorney ______________________________ Phone No. _____________________________ American LegalNet, Inc. www.FormsWorkFlow.com