GENERAL SESSIONS COURT OF ____________________ COUNTY, TENNESSEE STATE OF TENNESSEE vs. _______________________________________ Defendant State Control # __________________________ Case # _________________________________ CRIMINAL SUMMONS OFFICER’S RETURN TO THE DEFENDANT ( ) ( ) Based on the affidavit of complaint filed in this case, there is probable cause to believe that you have committed the offense(s) of violation(s) of T.C.A. § ___________________________________ _______________________________________ Name:_____________________________________ Address:____________________________________ DOB:___________________ Sex:______________ Race:___________________ Ht.:_______________ Wt.:_______ Hair:__________ Eyes:____________ Phone:__________________ DL#:______________ Place of Employment:_________________________ ___________________________________________ May be Found at:_____________________________ ___________________________________________ Other:______________________________________ ___________________________________________ ___________________________________________ WITNESSES Summon as witnesses on the part of the State: ___________________________________________ ___________________________________________ ___________________________________________ Summon as witnesses on the part of the Defendant: ___________________________________________ ___________________________________________ ___________________________________________ ________________________________ ________________________________ ( ) _______________________________________ _______________________________________ _______________________________________ INFORMATION ABOUT THE DEFENDANT Summons served by delivering a copy to defendant today or on ______________ Judge/Clerk/Judicial Commissioner Date YOU ARE HEREBY SUMMONED TO APPEAR ( ) In the booking room at _____________________ ___________________________________________ ( ) ________________________________ ________________________________ ________________________________ (address of booking office) Within ten (10) calendar days from date of service of this summons. ( ) To appear before the General Sessions Court of _________________________ County, Tennessee in ___________________________________________ Officer’s Signature: _______________________________________ to answer charges on ________________________ at ___________ a.m./p.m. Officer’s Name (Printed): NOTICE: YOU ARE CHARGED WITH A STATE CRIMINAL OFFENSE. THIS SUMMONS HAS BEEN ISSUED IN LIEU OF AN ARREST WARRANT. YOUR FAILURE TO APPEAR IN COURT ON THE DAY AND TIME ASSIGNED BY THIS SUMMONS OR THE FAILURE TO APPEAR FOR BOOKING AND PROCESSING WILL RESULT IN YOUR ARREST FOR SEPARATE CRIMINAL OFFENSE PUNISHABLE AS PROVIDED IN T.C.A. §39-16609 REGARDLESS OF THE DISPOSITION OF THE CHARGE FOR WHICH YOU WERE ORIGINALLY SUMMONED. YOU ARE ENCOURAGED TO CONSULT WITH AN ATTORNEY ABOUT THIS SUMMONS. THE SIGNING AND ACCEPTANCE OF THIS SUMMONS IS NOT AN ADMISSION OF GUILT OF THE CRIMINAL OFFENSE. Officer’s Agency (Printed): _______________________________________ _______________________________________ Date: __________________________________ _______________________________________ Defendant Date The summons must be executed in triplicate and must include a copy of the affidavit of complaint. Legal Authority: T. C. A. § 40-6-215; TRCRP 4 American LegalNet, Inc. www.USCourtForms.com