§ FORM 14 COMPLAINT ON A POLICY OF FIRE INSURANCE

Codes > Mississippi Rules of Civil Procedure > Chapter XI > Appendix A > FORM 14

FORM 14. COMPLAINT ON A POLICY OF FIRE INSURANCE

    1. On or about the _______ day of _______, defendant insured plaintiff's dwelling house (or other property, as the case may be) against loss or injury by fire and other perils in a policy of insurance, for the term of _______ years.

    2. The house (or other property) was wholly destroyed (or was damaged ) by fire on the _______ day of _______, of which the defendant has had notice.

    Wherefore plaintiff demands judgment against defendant in the sum of _______ dollars, interest and costs.

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