TENNESSEE COURTS
UNIFORM FACSIMILE FILING COVER SHEET
TO (COURT CLERK): _______________________________________________________________
WITH (COURT): ___________________________________________________________________
CLERK’S FAX NUMBER: ____________________________________________________________
CASE NAME: _____________________________________________________________________
DOCKET NUMBER: ________________________________________________________________
TITLE OF DOCUMENT: _____________________________________________________________
FROM (SENDER): _________________________________________________________________
SENDER’S ADDRESS: ______________________________________________________________
_________________________________________________________________________________
SENDER’S VOICE TELEPHONE NUMBER: _____________________________________________
SENDER’S FAX TELEPHONE NUMBER: _______________________________________________
DATE: _______________ TOTAL PAGES, INCLUDING COVER PAGE: ______________________
FILING INSTRUCTIONS/COMMENTS (attach additional sheet if necessary):
CONFIRMATION (For Clerk’s office use only)
This confirms that your facsimile filing listed above was processed by _____________ with
the filing date of _______________.
Your service charge pursuant to T.R.C.P. 5A.04 is $_______________.
Please send your payment along with this cover sheet within 10 days to:
Kathryn Strong
101 Public Square
P.O. Box 549
Gallatin, TN 37066
DENIED FOR FILING
Your facsimile listed above WAS NOT FILED OR PROCESSED due to the following deficiency:
The facsimile filing was longer than 10 pages and not pre-approved by the Court.
The document you attempted to file by facsimile transmission is prohibited from filing in this
manner by T.R.C.P. 5A.02(4)
Unless authorized by the Court, a facsimile transmission exceeding ten (10)
pages, including the cover page, shall not be filed by the clerk.
