Money Lent

(Title)

A.B.,
the above named plaintiff, states as follows:-

1.     1.On the day of 19,
he lent the defendant rupees repayable on the day of

2.     2.The defendant has
not paid the same, except rupees paid on the day of 19.

[If
the plaintiff claims exemption from any law of limitation, say:-]

1.      

2.      

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-manner of the suit 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 19.

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