SummonsCivil Action
__ Original
STATE OF TENNESSEE __ Alias
18
th
JUDICIAL DISTRICT __ Pluries
Circuit Court Sumner County, Tennessee
[ ] Local Sheriff
[ ] Out of County
[ ] Sec. of State
[ ] Comm. of Ins.
[ ] Attorney
[ ] Certified Mail
_________________________________________
_________________________________________
_________________________________________
Plaintiff(s)
vs. Case #_83CC1- -CV-
________________
_________________________________________
________________________________________
_________________________________________
_
Defendant(s)
TO THE ABOVE NAMED DEFENDANT(S):___________________________________________
You are hereby summoned to appear and defend a Civil Action filed against you in the Circuit
Court, Sumner County, Tennessee; and your defense must be made within thirty (30) days from the
date this summons is served upon you, exclusive of the day of service. You are further directed to file
your defense with the Clerk of this Court and send a copy to the Plaintiff’s Attorney,_______________
__________________________________________________ whose address is __________________
___________________________________________. In case of your failure to defend this action by
the above date, judgment by default can be rendered against you for the relief demanded in the
complaint.
TO THE SHERIFF: Execute this summons and make your return herein as provided by law.
WITNESS, Kathryn Strong, Clerk of the Circuit Court at Office in Gallatin, Tennessee.
Issued: ______________________, 20 ____.
KATHRYN STRONG, CLERK
By:_____________________D.C.
__________________________________________________________________________________
______________________________________________________________________
RECEIVED THIS SUMMONS FOR SERVICE, THIS ____ DAY OF ________________, 20 ___
________________________________________
Deputy Sheriff
RETURN ON SERVICE OF SUMMONS
I hereby certify and return that on the _________ day of ______________________, 20 ____
, I served this
summons together with a copy of the complaint herein as follows:
___________________________________________________________________________________________________
_______________
___________________________________________________________________________________
________________________________________
SHERIFF - DEPUTY SHERIFF
RETURN ON SERVICE OF SUMMONS BY MAIL
I hereby certify and return, that on the _______ day of ________________, 20 ____, I sent, postage
p
repaid, by registered return receipt mail or certified return receipt mail, a certified copy of the summons and a
copy of the complaint in Case No. ________________ to the defendant, _____________________________.
On the _________ day of _____________________, 20 ___, I received the return receipt for said
registered or certified mail, which had been signed by ______________________________________ on the
________ day of _________________________, 20 _______. Said return receipt is attached to this original
summons and both documents are being sent herewith to the Circuit Court Clerk for filing.
SW
ORN TO AND SUBSCRIBED BEFORE ME ON
TH
IS _______ DAY OF _________________ , 20 ___
_____________________________________________
PLAINTIFF/PLAINTIFF’S ATTORNEY OTHER
PERSON AUTHORIZED BY STATUTE TO SERVE
_______
______________________________________ PROCESS
_____NOTARY PUBLIC or ____DEPUTY CLERK
My Commission Expires: _________________
_______NOTICE________
TO THE DEFENDANT(S):
Tennessee law provides a ten thousand dollar
($10,000.00) debtor’s equity interest personal property
exemption from execution or seizure to satisfy a
judgment. 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 include items of
necessary wearing apparel (clothing) for yourself and
your family and trunks or 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 exercise it,
you may wish to seek the counsel of a lawyer.
ATT
ACH
RETURN RECEIPT
HERE
(IF APPLICABLE)
_______
___________________________________________________________________________________________
STATE OF TENNESSEE
COUNTY OF SUMNER
I, Kathryn Strong, Clerk of the Circuit Court in the State and County
a
foresaid, do hereby certify this to be a true and correct copy of the original
summons issued in this case.
(T
o be completed only if
copy certification required.)
Kathryn Strong, Clerk
By: _____
___________________
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