IN THE JUVENILE COURT OF MEMPHIS AND SHELBY COUNTY, TENNESSEEJC22681AIN THE MATTER OFA child(ren) under 18 years of ageDocket Number SUBPOENA AND NOTICESTATE OF TENNESSEETo any lawful officer:Notify that a petition for his/her Judicial Hospitalization has been filed on thebasis that he/she is mentally retarded and thereby "poses a likelihood of serious harm" as defined in TennesseeCode Annotated 247 33-5-305 and that he/she is ordered to appear before the Juvenile Court of Memphis and ShelbyCounty, Tennessee, at 616 Adams Avenue, Memphis, Tennessee, on the day of, 20 , at o'clock M., or as directed, to answer the Petition, acopy of which accompanies this Writ. Further, that he/she has the right to be represented by counsel at thehearing.Should the Court determine that he/she evidences a substantial risk of physical harm to himself/herself; or toothers; or an inability to protect himself/herself from harm, he/she will be committed to the custody and care ofthe Commissioner of the Department of Mental Health and Mental Retardation.Herein fail not, and have you then and there this Writ.Witness, J, Clerk of said Juvenile Court, at office, in Memphis, Tennessee, this day of, 20 .J, Clerk of CourtBy D. C. OFFICER'S RETURNCame to hand , 20 , and executed by This day of , 20 Officer//For assistance in accessing the courthouse:contactDanny Kail, Americans With Disability ActCOORDINATORPhone (901) 222-23 NOTICEAppropriate attire must be properlyworn to all court hearings andthroughout the court building by allin attendance. Violations should bebrought to the attention of the bailiffsfor enforcement. American LegalNet, Inc. www.FormsWorkFlow.com