GENERAL SESSIONS COURT OF ________________________________ COUNTY TENNESSEE State of Tennessee vs. _____________________________________________________________________________ State Control # _____________________ _______________________ County Case # _____________________ Attorney for Defendant _______________________________ Court Date _________________________________________ Address ________________________________________ _______________________________________________ State, Deft. to ________________________ at _____________am/pm State, Deft. to ________________________ at _____________am/pm State, Deft. to ________________________ at _____________am/pm State, Deft. to ________________________ at _____________am/pm State, Deft. to ________________________ at _____________am/pm Phone ___________________ DL# _______________________ DOB ____________________ SSN#______________________ Sex____ Race____ Ht____ Wt____ Hair____ Eyes __________ Work _______________________________________________ ____________________________________________________ AFFIDAVIT OF COMPLAINT I, the affiant named below, after being sworn, state under oath that on or about _________________________________ in ____________________________ County, Tennessee, ____________________________________________________ committed the offense(s) of violation(s) of T.C.A. § ______________________________________________________________. I further state under oath that the essential facts constituting the offense(s), the sources of my information and the reasons why this information is believable and reliable are as follows: Affiant’s Signature: ______________________________________ Sworn to and subscribed before me on Name (Printed): _________________________________________ _________________________________, 20____ Address (Printed): _______________________________________ ________________________________________ Judge/Clerk/Judicial Commissioner ______________________________________________________ Phone Number: _________________________________________ PROBABLE CAUSE DETERMINATION Based on the affidavit of complaint, I find there is probable cause to believe that on the date set forth above in_______________ County, Tennessee the defendant committed the offense(s) of violation(s) of TCA § ________________________________________________________ ____________________________________________________________________________________________________________________ ( ) Defendant given citation or arrested without warrant Date __________________________________ ( ) Arrest warrant shall issue ( ) Criminal summons shall issue Judge/Clerk/Judicial Commissioner ______________________________________ Legal Authority: TCA §§40-6-203, 40-6-204 ,TRCRP 3 American LegalNet, Inc. www.USCourtForms.com