CIVIL SUMMONS

STATE OF TENNESSEE, COUNTY OF___________________________________________
To Any Lawful Officer To Execute and Return: Summon_______________________________________________________________________________________________________________________________________
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 ___________________________________________________________________________

JUDGMENT

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_____.

________________________________________, Judge	Division_________________________________

ORDER

	_______________________________________________________________________________
	_______________________________________________________________________________
	_______________________________________________________________________________
	_______________________________________________________________________________
	_______________________________________________________________________________
	_______________________________________________________________________________
	_______________________________________________________________________________
This the _____ day of _________________________________, 20 _______.
_____________________________________________________, Judge

Case No. ________________________________________

_________________________________________________
Plaintiff
_________________________________________________
Address
_________________________________________________
Phone
vs.
_________________________________________________
Defendant
_________________________________________________
Address
_________________________________________________
Defendant
_________________________________________________
Address
CIVIL SUMMONS
Court of General Sessions
        (preprinted name)      , Clerk
By _____________________________, Deputy Clerk
Issued ______________________________, 20_____.
Set for ______________________________ at _____.
Reset for_____________________________________
Served Upon   All Named Defendants
          All Defendants Except:______________________________________
________________________________________________________________________________________
Served ______________________________, 20_____.
Sheriff/Constable (Process Server)
____________________________________________
____________________________________________
Attorney for Plaintiff 
Telephone __________________________________
_________________________________________________
Attorney for Defendant
Telephone ________________________________________

AFFIDAVIT

 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. ____________________________________

ADA: If you need assistance or accommodations because of a disability, please call __________________, ADA Coordinator, at 
(     ) _______________ 

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.

Legal Authority:  TCA §20-2-101, TRCP 3
				Rev. 8/10