§ FORM 13 COMPLAINT ON A POLICY OF LIFE INSURANCE

Codes > Mississippi Rules of Civil Procedure > Chapter XI > Appendix A > FORM 13

FORM 13. COMPLAINT ON A POLICY OF LIFE INSURANCE

    1. On or about the _______ day of _______, defendant issued a policy whereby the defendant insured the life of _______ who died on the _______ day of _______, of which the defendant has had notice.

    2. As a result, the amount of the policy is now due and the plaintiff is the beneficiary of the proceeds of the policy.

    Wherefore plaintiff demands judgment against defendant in the sum of _______ dollars, interest and costs.

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