..................................................................

To....................................................................

..........Dr.

To goods, wares, and merchandise, sold and delivered...

$........

To money lent and advanced ................................

$........

To money paid, laid out and expended..................

$........

To money had and received, to and for the use of said Plaintiff...............................................................

$........

To money due for interest and forbearance..........

$........

To labor, services, and material............................

$........

To balance due on account stated..........................

$........