A.B., the above named plaintiff, states as follows:–
1. On the …… day of …..19……, the defendant represented to the plaintiff the E.F., was solvent and in good credit, and worth….. rupees over all his liabilities [or that E.F, then held a responsible situation and was in good circumstances, and might safely be trusted with goods on credit.]
2. The Plaintiff was thereby induced to sell to E.F [rice] of the value of …… rupees [on …… months credit.]
3. The said representations were false and where then known by the defendant to be so, and were made by him with intent to deceive and defraud the plaintiff [or to deceive and injure the plaintiff.]
4. E.F [did not pay for the said goods at the expiration of the credit aforesaid, or] has not paid for the said rice, and the plaintiff has wholly lost the same.
[As in paras 4 and 5 of Form No. 1, and relief claimed.]