A.B., the above named plaintiff, states as follows:–
1. On the ……… day of ………… 20….., at ……., in the State [or Kingdom] of….., the …… court of that State [or
Kingdom], in a suit therein pending between the plaintiff and the defendant, duly adjudged that the
defendant should pay to the plaintiff ….. rupees, with interest from the said date.
2. The defendant has not paid the money.
[As in paras 4 and 5 of Form No. 1, and relief claimed.]