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 __________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 _________ dollars, interest, and costs.
　　Signed: ___________
　　Attorney for Plaintiff
　　Address: __________