Tennessee Code Title 6. Cities and Towns § 6-1-209

Petitions for adoption of this charter shall be in substantially the following form:

PETITION FOR INCORPORATION ELECTION FOR TOWN (CITY) OF __________, TENNESSEE

TO: The County Election Commission,

__________ County, Tennessee

We the undersigned, being registered voters and residents of the territory herein proposed for incorporation, and being in number in excess of thirty-three and one-third percent (33 1/3 %) of the registered voters of the herein described territory, hereby request the county election commission to hold an election on the question of whether or not the herein described territory shall be incorporated under the terms of Tennessee Code Annotated, title 6, chapters 1-4, and be known by the name and style of the “Town (City) of __________, Tennessee,” all as prescribed in Tennessee Code Annotated, title 6, chapters 1-4.

The territory in question, being part of the __________, Civil District(s) of __________ County, Tennessee, is further described as:

(Here insert a description of boundaries with references to tax maps)

The wards of the Town (City) shall be as follows:

(Here insert a description of wards, and if there is only one (1) ward state that the boundaries are as described above)

Wards that will carry an initial two-year term:

(For those municipalities incorporating with more than four (4) wards.) The proposed plan of services is as follows: (Here insert a description of the plan of services as defined in Tennessee Code Annotated, § 6-1-203).

I, __________, hereby certify that I personally solicited the signatures of the persons appearing on this page and that they, in fact, signed their names to this petition in my presence.

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 such person executed it as such person's free act and deed.

My commission expires: __________