A.B., the above named plaintiff, states as follows:–
1. On the ……. day of ….. 20….., the defendant obtained a warrant of arrest from ……. [a Magistrate of the said city, or as the case may be] on a charge of….., and the plaintiff was arrested thereon, and imprisoned for… [days, or hours, and gave bail in the sum of …… rupees to obtain his release.]
2. In so doing the defendant acted maliciously and without reasonable or probable cause.
3. On the ….. day of….. 20….., the Magistrate dismissed the complaint of the defendant and acquitted the plaintiff.
4. Many persons, whose names are unknown to the plaintiff, hearing of the arrest, and supposing the plaintiff to be a criminal, have ceased to do business with him; or in consequence of the said arrest, the plaintiff lost his situation as clerk to one E.F., or in consequence the plaintiff suffered pain of body and mind, and was prevented from transacting his business, and was injured in his credit, and incurred expenses in obtaining his release from the said imprisonment and in defending himself against the said compliant.
[As in paras 4 and 5 of Form No. 1, and relief claimed.]