Form 3. Complaint on a Promissory Note
1. Allegation of jurisdiction.
2. Defendant on or about June 1, 1935, 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, 1936 the sum of XXX dollars with interest thereon at the rate of six percent. per annum].
3. Defendant owes to plaintiff the amount of said note and interest.
Wherefore plaintiff demands judgment against defendant for the sum of XXX dollars, interest, and costs.
Signed: XXXXXXXXXXXXXX,
Attorney for Plaintiff.
Address: XXXXXXXXXXXXX