STATE OF TENNESSEE, COUNTY OF___________________________________________ CIVIL SUMMONS To Any Lawful Officer To Execute and Return: Summon_________________________________________________________________ Case No. ________________________________________ _________________________________________________ Plaintiff _________________________________________________ Address _________________________________________________ Phone vs. _________________________________________________ Defendant _________________________________________________ Address _________________________________________________ Defendant _________________________________________________ Address ______________________________________________________________________ To appear before the General Sessions Court of______________________________________ _______________________, County, Tennessee. To be held in ________________________ ___________________________ (Court Room)_____________________________(Address) on the _______ day of _____________________, 20_____ at ______ p.m./a.m., then and there to answer in a civil action brought by________________________________________________________ for ___________________________________________________________________________________ ______________________________________________________________________________________ Under $_______________________________________________________________________________ Judgment for ___________________________________________________________________________ Against _________________________________________________________________________ For $__________________ plus interest at the rate of ________% and cost of suit, for which execution may issue. Judgment entered by: Default Agreement Trial Dismissed: Without Prejudice With Prejudice Costs taxed to: Plaintiff Defendant Defendant(s)______________________________________________________________ in court and admitted to jurisdiction of court. This the ______ day of _____________________, 20_____. JUDGMENT CIVIL SUMMONS Court of General Sessions (preprinted name) , Clerk By _____________________________, Deputy Clerk Issued ______________________________, 20_____. ________________________________________, Judge Division_________________________________ Set for ______________________________ at _____. Reset for_____________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ This the _____ day of _________________________________, 20 _______. _____________________________________________________, Judge ORDER Served Upon All Named Defendants All Defendants Except:______________________________________ ____________________________________________ ____________________________________________ Served ______________________________, 20_____. Sheriff/Constable (Process Server) ____________________________________________ ____________________________________________ Attorney for Plaintiff Telephone __________________________________ _________________________________________________ Attorney for Defendant Telephone ________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com To the best of my information and belief, after investigation of Defendant's employment, I hereby make affidavit that the Defendant is/is not a member of a military service. _________________________________________________________________ Attorney for Plaintiff or Plaintiff _________________________________________________________________ Notary Public My Comm. Exp. ____________________________________ AFFIDAVIT TO THE DEFENDANT(S): Failure to appear and answer this summons may result in judgment by default being rendered against you for the relief requested. Tennessee law provides a ten thousand dollar ($10,000) personal property exemption as well as a homestead exemption from execution or seizure to satisfy a judgment. The amount of the homestead exemption depends upon your age and the other factors which are listed in TCA § 26-2-301. If a judgment should be entered against you in this action and you wish to claim property as exempt, you must file a written list, under oath, of the items you wish to claim as exempt with the clerk of the court. The list may be filed at any time and may be changed by you thereafter as necessary; however, unless it is filed before the judgment becomes final, it will not be effective as to any execution or garnishment issued prior to the filing of the list. Certain items are automatically exempt by law and do not need to be listed; these items include items of necessary wearing apparel (clothing) for yourself and your family and trunks and other receptacles necessary to contain such apparel, family portraits, the family Bible, and school books. Should any of these items be seized you would have the right to recover them. If you do not understand your exemption right or how to execute it, you may wish to seek the counsel of a lawyer. ADA: If you need assistance or accommodations because of a disability, please call __________________, ADA Coordinator, at ( ) _______________ Legal Authority: TCA §20-2-101, TRCP 3 American LegalNet, Inc. www.FormsWorkFlow.com Rev. 8/10