Fill and Sign the Actual Damages Form

1 23456789 10111213141516171819202122232425 262728 - 1 - [INSERT CAPTION AND STYLE] COMPLAINT (BREACH OF CONTRACT SINGLE COUNT) PARTIES 1. The Plaintiff, [insert name of plaintiff ] at all times relevant hereto, is an adult citizen of the State of [ insert state jurisdiction] and resides in [insert county name ]. 2. The Defendant, [ insert name of defendant ] at all times relevant hereto, is: (INSERT 1 OR MORE OF THE FOLLOWING) (1) a corporation incorporated under the laws of the State of [ insert state of incorporation] and is [or is not] authorized to do business as a foreign corporation in this State, and is subject to service of process by and through its registered agent: [ insert name and address of registered agent ]; (2) an adult citizen of the State of [ insert defendants state of residency] who resides at [ inserts defendant’s street address, city and zip code ] and is subject to service of process. FACTS: 3. On or about [insert date] the Plaintiff and Defendant entered into a written contract, a copy of which is attached hereto, made a part hereof, and is marked as Exhibit A (hereinafter referred to as the Contract) [ or, if a copy of the contract is not attached, state the reasons why it is not attached ]. Said contract provides that the laws of the State of [ insert state of jurisdiction ] shall govern the Contract. 4. Pursuant to the Contract, the Plaintiff agreed to: [ insert a description of the plaintiff’s duties and obligations under the contract ], and the Defendant agreed to: [insert description of defendant’s duties and obligation under the contract]. 5. On or about [ insert date] the Defendant breached the Contract by: [ insert facts 1 23456789 10111213141516171819202122232425 262728 - 2 - giving rise to defendants breach of the contract , e.g., failure to perform duty or obligation ]. 6. On or about [ insert date] Plaintiff gave notice of breach of contract and demand for performance to the Defendant. CLAIMS: 7. The Defendant’s breach of the Contract delineated hereinabove proximately caused Plaintiff to suffer: [ insert amount of contract damages ]. 8. Plaintiff has performed all conditions precedent to recovery and has not excused defendant’s non-performance or breach of the Contract. DEMAND FOR RELIEF: WHEREFORE, the Plaintiffs pray for the following relief: 1. Trial by jury; 2. Judgment for Plaintiff(s) and against the Defendant(s); 3. An award of damages in an amount which will fully and fairly compensate Plaintiff for [ insert types of damages from claims section above ]. 4. Reasonable attorney fees, costs and expenses ( if provided for in the Contract or allowed by statute ); 5. Such other and further relief as may be deemed just and proper in the premises.