Circuit Court of the United States.

For the................District of................

Of the..................Term, A. D. 190......

United States of America, ........District of......

ss.

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

who............citizen, .of the State of............Plaintiff.. in this suit, by................................Attorney.. complain.. of...........

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who............citizen.. of the State of..................Defendant. ...

who ha.. been duly summoned to answer the Plaintiff.. in a plea of trespass on the case on promises.

For that, Whereas, The said Defendant...............heretofore, to wit: on the................day of..................in the year of our

Lord One Thousand Nine Hundred................at..............to wit: at said District,......................................................

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And Whereas, also, The said Defendant.. afterwards, to wit: on the........................day of........................in the year of our Lord One Thousand Nine Hundred............................to wit: at the District aforesaid, became and......................indebted to the said Plaintiff.. in a large sum of money, to wit: the sum of...............

....................Dollars, of lawful money, for the work and labor, care and diligence, attention and attendance, of the said Plaintiff.. by the said Plaintiff.. before that time done, performed, bestowed and given, in and about the goods, chattels, wares, machinery, property, premises, possessions and business of the said Defendant.. and for the said Defendant.., and at the special instance and request of said Defendant.., and also for divers materials and other necessary things by the said Plaintiff.. before that time found, furnished, provided, used and applied in and about that work, and labor for the said Defendant.. at the like special instance and request of said Defendant .., and being so indebted to the said Plaintiff.., the said Defendant.. in consideration thereof, afterwards, to wit: on the same day and year, and at the place aforesaid, undertook, and then and there faithfully promised the said Plaintiff.. well and truly to pay to said Plaintiff, .said sum of money last mentioned, when the said Defendant.. should be thereunto afterwards requested.

And Whereas, also, Afterwards, to wit: on the same day and year, and at the place aforesaid, in consideration that the said Plaintiff.. had before that time done, performed, bestowed and given other work and labor, care and diligence, attention and attendance, of the said Plaintiff.. in and about the goods, chattels, wares, machinery, property, premises, possessions and business of the said Defendant.., at the request of said Defendant.., and had also, at the like special instance and request of said Defendant.., before that time found, furnished, provided, used and applied divers other materials and necessary things in and about the said last mentioned work and labor of the 6aid Plaintiff., the said Defendant., undertook, and then and there faithfully promised the said Plaintiff, .well and truly to pay to the said Plaintiff.., so much money as the last aforesaid work and labor and materials of said Plaintiff.. at the time aforesaid, were reasonably worth, when said Defendant.. should be thereunto afterwards requested; and the said Plaintiff.. aver.. that the same, at said time, were reasonably worth the further large sum of...........................................Dollars, of like lawful money, at the time and place aforesaid, whereof the said Defendant.., afterwards, to wit: at the time and place aforesaid, had notice.

And Whereas, also, The said Defendant.., afterwards, to wit: on the same day and year, and at the place aforesaid, became and................

indebted to the said Plaintiff.. in a large sum of money, to wit: the sum of...........................................................Dollars, of lawful money, for divers goods, wares and merchandise, by the said Plaintiff.. before that time sold and delivered to the said Defendant.., and at the special instance and request of the said Defendant.., and being so indebted to the said Plaintiff.., the said Defendant.. in consideration thereof, afterwards, to wit: on the same day and year, and at the place aforesaid, undertook, and then and there faithfully promised the said Plaintiff.. well and truly to pay to the said Plaintiff.. the said sum of money last mentioned, when the said Defendant.. should be thereunto afterwards requested.

And Whereas, also, Afterwards, to wit: on the 6ame day and year, and at the place aforesaid, in consideration that the said Plaintiff.. had before that time, at the like special instance and request of the said Defendant.., sold and delivered to the said Defendant.. divers other goods, wares and merchandise of the said Plaintiff. ., the said Defendant.. then and there undertook and faithfully promised the said Plaintiff, .that the said Defendant. . would well and truly pay to the said Plaintiff.. so much money as the last aforesaid goods, wares and merchandise, at the time of the sale and delivery thereof, were reasonably worth, when the said Defendant.. should be thereunto afterwards requested; and the said Plaintiff.. aver.. that the said goods, wares and merchandise last mentioned, at the time of the sale and delivery thereof, were reasonably worth the further large sum of money, to wit: the sum of.............................................Dollars, of like lawful money aforesaid, to wit: at the place aforesaid, whereof the said Defendant.. afterwards, on the same day and year, and at the place aforesaid, had notice.

And Whereas, also, The said Defendant.. afterwards, to wit: on the same day and year, and at the place aforesaid,....................indebted to the said Plaintiff.. in the further large sum of money, to wit: the sum of.....................................................Dollars, of like lawful money, as aforesaid, for money before that time lent and advanced by the said Plaintiff.. to the said Defendant.., and at the like request of the said Defendant..; And for other money by the said Plaintiff.. before that time paid, laid out and expended for the said Defendant.., and at the like request of the said Defendant. .; And for other money by the said Defendant.. before that time had and received, to and for the use of the said Plaintiff..; And for other money before that time and then due and owing the said Plaintiff.., for interest upon and for the forbearance or divers other sums of money, before that time and then due and owing from said Defendant.. to said Plaintiff..; And being so indebted, the said Defendant.., in consideration thereof, afterwards, to wit: on the same day and year, and at the place aforesaid, undertook, and then and there faithfully promised the said Plaintiff. . well and truly to pay unto the said Plaintiff.. the said several sums of money in this count mentioned, when the said Defendant.. should be thereunto afterwards requested.

And Whereas, also, The said Defendant.., afterwards, to wit: on the same day and year, and at the place aforesaid, accounted with the said Plaintiff.. of and concerning divers other sums of money, before that time due and owing from the said Defendant.. to the said Plaintiff.., and then and there being in arrear and unpaid, and upon such accounting the said

Defendant.. then and there..............found to be in arrear and indebted to the said Plaintiff.. in the further large sum of money, to wit: the sum of.....................................................Dollars, of like lawful money as aforesaid. And being so found in arrear and indebted to the said Plaintiff.., the said Defendant.., in consideration thereof, afterwards, to wit: on the same day and year, and at the place aforesaid, undertook, and then and there faithfully promised the said Plaintiff.. well and truly to pay unto the said Plaintiff.. the said sum of money last mentioned, when the said Defendant.. should be thereunto afterwards requested.

Nevertheless, The said Defendant.. (although often requested, etc.) ha.. not yet paid the several said sums of money above mentioned, or any or either of them, or any part thereof, to the said Plaintiff.., but to pay the same, or any part thereof, to the said Plaintiff.., the said Defendant.. ha.. hitherto altogether refused, and still do.. refuse, to the damage of the said

Plaintiff.., of.................................................Dollars, and therefore the said Plaintiff.. bring.. suit, etc.

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Plaintiff's Attorney.