Fill and Sign the Assault 497330789 Form

IN THE _________________ COURT OF ___________________ (County), ____________________ (State) _________________________ PLAINTIFF (Name of Plaintiff) V. CAUSE NO. _____________ _________________________ DEFENDANT (Name of Defendant) COMPLAINT COMES NOW ________________________ (Name of Plaintiff) , Plaintiff in the above-styled and numbered cause, by and through his attorney, and files this his Complaint against Defendant, ___________________________ (Name of Defendant), and in support thereof would show unto the Court the following matters and facts: I. Plaintiff is an adult resident citizen of ___________________________________ (city, county, state) . II. Defendant is an adult resident citizen of ________________________________ (city, county, state) . III. On ________________________ (date) was in the _______________________ (name) branch of _____________________________________ (name of bank) at ______________________________________________________________________ _______________ (street address, city, county, state, zip code) , d epositing a check. IV. At the time and place mentioned above, Defendant, Manager of said Branch, willfully, maliciously, and without cause or provocation (describe the assault and battery, such as: struck Plaintiff numerous times about his head and body) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ all of which caused the injuries to Plaintiff described below. V. At the time of the assault and battery on ______________________________ (Plaintiff) , Plaintiff suffered from a heart condition. VI. As a direct and proximate result of the said assault and battery on Plaintiff, Plaintiff suffered (describe) _______________________________________________ ______________________________________________________________________ ______________________________________________________________________ . VII. As a further direct and proximate result of the said assault and battery, Plaintiff has incurred and will in the future incur substantial medical and hospital expenses in a sum exceeding $_______________. WHEREFORE, Plaintiff requests judgment against Defendant : 1. In the amount of $_____________, as damages; 2. Awarding Plaintiff the costs of this action; and 3. Granting Plaintiff such other and further relief as the Court deems just and proper. Respectfully Submitted, _____________________________ Name of Plaintiff By: __________________________ Name of Attorney Bar No. _______________ Of Counsel: Attorney for Plaintiff Post Office Box ___________ _________________________________________ City, State, Zip Code Telephone: ________________________