___________ Court __________ County __________ Tennessee
INVENTORY
Case Number
_____________________________________ vs. ______________________________________
Pursuant to TCA 29-30-104(f), the following language should appear as an attachment to the summons to recover personal property if the action is to recover personal property to satisfy a lien on a motor vehicle for repayment of loan: I (we), _________________________________________________________________, the defendants herein, acknowledge that the following items are attached to or are a part of the motor vehicle which is the subject of this action as described by the officer serving process:
(1) ________________________________________________ (tires, type and model)
(2) ________________________________________________ (radio equipment)
(3) ________________________________________________ (stero or tape equipment)
(4) ________________________________________________ (citizen's band radio)
(5) ________________________________________________ (other special items added to vehicle after purchase)
_____________________________________ Defendant _____________________________________ Defendant
__________________ Date __________________ Date
_____________________________________ Officer Serving Process
__________________ Date