Appeal Bond For Costs Form

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APPEAL BOND FOR COSTS
I (we), ___________________________________________________________________,
principal(s)/Appellant(s), and I (we), _____________________________________________, the
surety(ies)/Attorney, bind myself/ourselves for the costs of appeal in:
____________________________________________________________________________
vs.
Docket No. _______________________
_________________________________________________________________
_____________________________________,
or
PRINCIPAL/APPELLANT (Signature)
_____________________________________ by __________________________________________
PRINCIPAL (Print)
ATTORNEY (Signature)
PRINCIPAL’S ADDRESS:
______________________________________________________________________
______________________________________________________________________
PRINCIPAL(S) SOCIAL SECURITY NO.: _____________________________
PRINCIPAL(S) DRIVER’S LICENSE NO.: _____________________________
(street address only; NO P.O. boxes; NO in care of principal’s attorney)
§
(Social Security/Driver’s License Numbers required for individual principal(s) per Tenn. Code Ann.
25-1-108)
•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••
_______________________________
by __________________________________SURETY
(Print)
(Signature)
Note: If you are signing as surety on behalf of a law firm, please print the name of the firm on the space provided. If you
are signing as an individual surety, please print your name. If you sign as an individual surety, you are personally
responsible for the costs should the principal fail to pay.
SURETY’S ADDRESS: ____________________________________________________________
_________________________________________________________________________________
NO
(street address only:
P. O. boxes)
IF THE PRINCIPAL(S) PAY ALL COSTS OF APPEAL, THEN THIS OBLIGATION IS
VOID. IF PRINCIPAL(S) FAIL(S) TO PAY, THEN THE SURETY IS OBLIGATED TO PAY
ALL COSTS OF APPEAL.
IF YOU DO NOT HAVE A SURETY TO SIGN YOUR BOND FOR COSTS: A cash deposit of
$1,000.00 is deemed sufficient instead of a surety bond, except as otherwise required by the trial court
clerk and/or the Appellate Court Clerk.
A deposit of $__________ in cash has been made by ______________________________________
with ________________________________ of the ___________________________________ court
clerk’s office on the __________ day of _________________________, 200___.
APPROVED:
________________________________________ or ___________________________________
CLERK OF THE TRIAL COURT
CLERK OF THE APPELLATE COURT

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