A.B., the above named plaintiff, executor of the will of X. Y., deceased, states as follows:–
1. That the defendant occupied the [house No…….., Street], by permission of the said X.Y., from the ……. day
of ……. 19……, until the ……. day of …….. 19……., and no agreement was made as to payment for the use of
said premises.
2. That the use of the said premises for the said period was reasonably worth …… rupees.
3. The defendant has not paid the money.[As in paras 4 and 5 of Form No. 1.] 6. The plaintiff as executor of X.Y claims [Relief Claimed.]