State of Tennessee
County of Rutherford
Personally appeared before me, ______________________________, Clerk of the County Court of said County
___________________________________, Administrator, Executor, Conservator or Guardian who being duly
sworn deposed and said that the foregoing is just and true, and perfect accounting of all and singular, the goods
and chattels of the Estate of ____________________________________________________________________,
that has or should have come to my/our hands since the ___________ day of ________________, __________
to the best of my knowledge, information and belief.
___________________________________________
Administrator, Executor, Conservator or Guardian
Subscribed and sworn to before me this _________ day of ___________________________, _____________.
___________________________________________
County Clerk
__________________________________________
Deputy Clerk