AFFIDAVIT Comes the Affiant (Printed Name) Under penalties of perjury, affiant deposes and says, to wit as follows: 1. I was awarded the attached civil judgment based upon the criminal conduct of another. 2. The attached judgment of conviction was the result of the criminal conduct. 3. The civil judgment and the judgment of conviction were based upon the same conduct. 4. The provision of § 28-3-110(b) is applicable to affiant pursuant to § 28-3-110(c). Further Affiant Saith Not Signature of Affiant ACKNOWLEDGEMENT State of Tennessee County of On this day of , 20 , before me personally appeared to me known to be the person described in and who executed the foregoing instrument, and acknowledged that he/she executed the same as his/her free act and deed, for the purposes therein set forth. (County Clerk) (Notary Public) My Commission Expires 20
Click to view form.
Code 1858, § 2776; Shan., § 4473; Code 1932, § 8601; modified; T.C.A. (orig. ed.), § 28-310; Acts 2014, ch. 596, § 1; 2020, ch. 596, § 1.
Structure 2021 Tennessee Code
Title 28 - Limitation of Actions
Chapter 3 - Limitation of Actions Other Than Real
Part 1 - Miscellaneous Limitations
§ 28-3-102. Actions Against Personal Representative
§ 28-3-104. Personal Tort Actions; Actions Against Certain Professionals
§ 28-3-105. Property Tort Actions — Statutory Liabilities
§ 28-3-106. Recovery of Gambling Losses
§ 28-3-108. Actions Against Sureties of Collecting Officer
§ 28-3-111. Open Accounts of Merchants