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Case 2:13-cv-02594-dkv Document 1-2 Filed 08/02/13 Page 1 of 2 PageID 5

State of Tennessee, County of Shelby.

ICIVIL WARRANT NO.]

94 L b

To Any Lawful Officer to Execute and Return:
Summon to appear before the Court of General Sessions of Shelby County, Tenne~e, Room 106
Shelby County Courthouse, 140 Adams Ave., Memphis, Tennessee

-

LIBERTY MUTUAL GROUP, INC. by serving their agent for service of process:
Defendant
Defendant
CORPORATION SERVICE COMPANY, 2908 POSTON AVENUE, NASHVILLE, T '37
Address

Defendant.

Address

Address

-a

p~

r

on DAY-EidayL.

DATO

"

to

F2ffO~'

A./P.M.

to answer in a civil action brought by the Plaintiff (s) JEANETTE FLEWELLING
for breach of benefits contract, violation of T.C.A. 56-7-105, punitive damagjes, Plus Court Costs,
Attorney Fees and PPS fees.

Atty. For PItt. J.D. BARTON
Issued this___ day of
EDWARD L. STANFORD, JR., Clerk Pro Tempore
of General Sessions Court

20-

-

By

Deputy Clerk

Address

Poe(0)8249
Code No.
B.P.R. No.

_____________

6565 Hwy 51 N, Millington, TN

B03891
13494

Judgment for_____________________________

OUDGMENT

and Cost

of suit and litigation taxes, for which Execution may issue.

* This

day

20

_____________________

Judge of Division

Came to hand same day issued and executed as Came to hand same day issued and executed as

* commanded on _______________commanded

on ______________

This_______ day of

20 _

This

Sheriff/Process Server

***SEE OTHER SIDE FOR ADDITIONAL SERVICE****

****AND NOTICE TO DEFENDANT(S)""*

day of

20
Sheriff/Process Server

Case 2:13-cv-02594-dkv Document 1-2 Filed 08/02/13 Page 2 of 2 PageID 6

Came to hand same day issued and executed as
commanded on

Came to hand same day issued and executed as
commanded on

This_______ day of______ 20 __

Sheriff/Process Server

This

day of

20-

Sheriff/Process Server

TO THE DEFENDANT (S):

Pursuant to Tennessee code annotated 26-2-114, you are hereby given the following notice:

Tennessee law provides a four thousand dollar ($4,000.00) 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 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.

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.

AFFIDAVIT

Attorney for Plaintiff or Plaintiff

-. Notary Public

My Commission Expires.