§ FORM 9. Complaint for Negligence

Codes > West Virginia Rules of Civil Procedure > Appendix of > FORM 9.

FORM 9. Complaint for Negligence

1. On June 1, 1955, in a public highway called Washington Street in Charleston, West Virginia, 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 one thousand dollars.

Wherefore plaintiff demands judgment against defendant in the sum of ten thousand dollars and costs.