Form 1.942 Check
Plaintiff, A. B., sues defendant, C. D., and alleges:
1. This is an action for damages that (insert jurisdictional amount).
2. On …..(date)….., defendant executed a written order for the payment of $………., commonly called a check, a copy being attached, payable to the order of plaintiff and delivered it to plaintiff.
3. The check was presented for payment to the drawee bank but payment was refused.
4. Plaintiff holds the check and it has not been paid.
5. Defendant owes plaintiff $………. that is due with interest from …..(date)….., on the check.
WHEREFORE plaintiff demands judgment for damages against defendant.
NOTE: A copy of the check must be attached. Allegations about endorsements are omitted from the form and must be added when proper.