2017 Georgia Code
Title 9 - Civil Practice
Chapter 11 - Civil Practice Act
Article 10 - Forms
§ 9-11-109. Form of complaint for negligence
IN THE ____ COURT OF ____ COUNTY
STATE OF GEORGIA
A.B., )
Plaintiff )
)
v. ) Civil action
) File no. ____
C.D., ) (Clerk will insert
Defendant ) number.)
COMPLAINT
The defendant C.D., herein named, is a resident of ____ (street), ____
(city), ____ County, Georgia, and is subject to the jurisdiction of this
court.
1.
On June 1, 1966, on a public highway called Broad Street in Athens,
Georgia, defendant negligently drove a motor vehicle against plaintiff who was
then crossing said highway.
2.
As a result plaintiff was thrown down and had his leg broken and was
otherwise injured, was prevented from transacting his business, suffered great
pain of body and mind, and incurred expenses for medical attention and
hospitalization in the sum of $1,000.00.
Wherefore, plaintiff demands judgment against defendant in the sum of
$10,000.00 and costs.
____
Attorney for plaintiff
____
Address
