IN THE COURT OF COUNTY

STATE OF GEORGIA

A.B., )

Plaintiff )

)

v. ) Civil action

) File no.

C.D., ) (Clerk will insert

Defendant ) number.)

COMPLAINT

The defendant C.D., herein named, is a resident of (street), (city), County, Georgia, and is subject to the jurisdiction of this court.

Defendant owes plaintiff $10,000.00 for money had and received from one G.H. on June 1, 1966, to be paid by defendant to plaintiff.

Wherefore, plaintiff demands judgment against defendant for the sum of $10,000.00, interest, costs, and attorney fees (where applicable). Attorney for plaintiff Address