IN THE JUVENILE COURT OF MEMPHIS AND SHELBY COUNTY, TENNESSEE IN THE MATER OF Docket Number A child(ren) under 18 years of age SUMMONS STATE OF TENNESSEE To any lawful officer: Summon to appear before the Juvenile Court of Memphis and Shelby County, Tennessee, at 616 Adams Avenue, on the day of , 20 , at o'clock M., to answer the charge of the petition, a copy of which accompanies this summons, and further, notify him that failure to appear will result in a JUDGMENT BY DEFAULT being entered against him for the relief demanded in the petition. Herein fail not, and have you then and there this Writ. WITNESS, JANIS FULLILOVE, Clerk of said Juvenile Court, at office, in Memphis, Tennessee, this day of , 20 . JANIS FULLILOVE, Clerk of Court By D.C. OFFICER'S RETURN Came to hand , 20 , and executed by This day of , 20 Officer Please call (901) 222-2357 for assistance entering the Juvenile Court Building during business hours 09/01/2018 REV A DM JC-004 NOTICE Appropriate attire must be properly worn to all court hearings and throughout the court building by all in attendance. Violations should be brought to the attention of the bailiffs for enforcement. American LegalNet, Inc. www.FormsWorkFlow.com