Money Lent
In the Court of ......................................
A.B. (add description and residence) ...................... Plaintiff
against
C.D. (add description and residence) .................... Defendant
A.B., the above-named plaintiff, states as follows :
1. On the ................ day of 200 ........ ................ He lent the defendant rupees repayable on the ................day of ................
2. The defendant has not paid the same, except................rupees paid on the .....day of ................200.......
[If the plaintiff claims exemption from any law of limitation, say :]
3. The plaintiff was a minor [or insane] from the ................ day of till.... .. ...the ................day of................
4. [Facts showing when the cause of action arose and that the Court has jurisdiction. ]
5. The value of the subject-matter of the suit for the purpose of jurisdiction is ................rupees and for the purpose of court-fees is ................rupees.
6. The plaintiff claims ................rupees, with interest at ................percent, from the ................day of ................200........
Dated :
Plaintiff
Through, Advocate
Verification:
I, ______, do hereby verify that the contents from paras 1 to ______ are correct and true to the best of my knowledge and personal belief and no part of it is false and nothing material has been concealed therein.
Affirmed at Coimbatore this ______.
Plaintiff