§ Form 3 Complaint on a Promissory Note

Form 3. Complaint on a Promissory Note

    1. (Here set out the grounds upon which the court's jurisdiction depends.)

    2. Defendant on or about June 1, 1975, executed and delivered to plaintiff a promissory note [in the following words and figures: (here set out the note verbatim) ]; [a copy of which is hereto annexed as Exhibit A]; [whereby defendant promised to pay to plaintiff or order on June 1, 1976 the sum of ten thousand dollars ($10,000.00) with interest thereon at the rate of six per cent per annum].

    3. Defendant owes to plaintiff the amount of said note and interest. Wherefore plaintiff demands judgment against defendant for the sum of ten thousand dollars ($10,000.00), interest, and costs.

              Signed: ________________________________________________________________________________

                                                                                                                                                        Attorney for Plaintiff            Address:________________________________________________________________________________