Section 9-11-103. Form of complaint on a promissory note

                      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.
 
 
                                      1.                                       

 
   Defendant on or about June 1, 1965, 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, 1966, the sum of $10,000.00 
with interest thereon at the rate of 6 percent per annum.
 
 
                                      2.                                       

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

Ga. L. 1966, p. 609, § 103; Ga. L. 1980, p. 649, § 1.