2019 Georgia Code
Title 9 - Civil Practice
Chapter 11 - Civil Practice Act
Article 10 - Forms
§ 9-11-118. Form of complaint for interpleader and declaratory relief

• IN THE COURT OF COUNTY

  • STATE OF GEORGIA

  • A.B., )

  • Plaintiff )

  • )

  • v. ) Civil action

  • ) File no.

  • C.D., E.F., and X.Y., ) (Clerk will insert

  • Defendants ) 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. (Add appropriate statement about domicile of remaining defendants.)

  • 1. On or about June 1, 1965, plaintiff issued to G.H. a policy of life

    • insurance whereby plaintiff promised to pay to K.L. as beneficiary the sum of

    • $10,000.00 upon the death of G.H. The policy required the payment by G.H. of a

    • stipulated premium on June 1, 1966, and annually thereafter as a condition

    • precedent to its continuance in force.

  • 2. No part of the premium due June 1, 1966, was ever paid and the policy

    ceased to have any force or effect after July 1, 1966.

  • 3. Thereafter, on September 1, 1966, G.H. and K.L. died as the result of a

    • collision between a locomotive and the automobile in which G.H. and K.L. were

    • riding.

  • 4. Defendant C.D. is the duly appointed and acting executor of the will of

    • G.H., defendant E.F. is the duly appointed and acting executor of the will of

    • K.L., and defendant X.Y. claims to have been duly designated as beneficiary of

    • said policy in place of K.L.

  • 5. Each of the defendants, C.D., E.F., and X.Y., is claiming that the

    • above-mentioned policy was in full force and effect at the time of the death

    • of G.H.; each of them is claiming to be the only person entitled to receive

    • payment of the amount of the policy and has made demand for payment thereof.

  • 6.

• By reason of these conflicting claims of the defendants, plaintiff is in

  • great doubt as to which defendant is entitled to be paid the amount of the

  • policy if it was in force at the time of death of G.H.

  • Wherefore, plaintiff demands that the court adjudge:

  • (1) That none of the defendants is entitled to recover from plaintiff

    the amount of said policy or any part thereof.

  • (2) That each of the defendants be restrained from instituting any

    • action against plaintiff for the recovery of the amount of said policy or any

    • part thereof.

  • (3) That, if the court shall determine that said policy was in force at

    • the death of G.H., the defendants be required to interplead and settle between

    • themselves their rights to the money due under said policy and that plaintiff

    • be discharged from all liability in the premises except to the person whom the

    • court shall adjudge entitled to the amount of said policy.

  • (4) That plaintiff recover its costs.

• • Attorney for plaintiff

  • Address

Ga. L. 1966, p. 609, § 120; Ga. L. 1980, p. 649, § 13; Ga. L. 1984, p. 22, § 9; Ga. L. 2006, p. 72, § 9/SB 465.