[Dec. 18.] THE NEW ZEALAND GAZETTE. 3589

No. 25.--CLAIM FOR WORK DONE BY CONTRACT.
THE plaintiff claims £ for materials furnished and work and labour done by the plaintiff for
the defendant at his request, in [State work done] under a written agreement entered into by the
plaintiff with the defendant on the day of , 19 , as follows : [Insert items, with
dates and amounts].

No. 26.--CLAIM FOR WRONGFUL DISMISSAL.
THE plaintiff claims £ for that, the plaintiff being the hired servant of the defendant at the
wages of £ per year, payable monthly, the defendant wrongfully dismissed the plaintiff on
the day of , 19 , during the current year of his service.

No. 27.--CLAIM FOR MONEY LENT.
THE plaintiff claims £ , the amount of money lent by the plaintiff to the defendant on the
day of , 19 , and which has not been repaid [or, if lent at several times, say
“as follows,” and insert dates and amounts].

No. 28.--CLAIM FOR MONEY PAID.
THE plaintiff claims £ , the amount of money paid by the plaintiff to A. B. for the defendant
at his request on the day of , 19 [or, if paid at several times or to different persons,
say, “as follows,” and insert dates, names, and amounts.]

No. 29.--ACTION FOR CONTRIBUTION (SECTION 56 OF ACT).
THE plaintiff claims £ as the amount of contribution due in law from the defendant to the
plaintiff by reason of the plaintiff having been sued in the Magistrate’s Court at by A. B.
for the sum of £ , recoverable against the plaintiff and the defendant jointly, and judgment
recovered against the plaintiff, and paid and satisfied by him on the day of , 19 .
The plaintiff claims the same sum as money paid by him to defendant’s use. The statement of claim
plaintiff was sued on is as underwritten [or hereto attached].

No. 30.--CLAIM FOR MONEY HAD AND RECEIVED.
THE plaintiff claims £ , the amount of money received by the defendant on or about the
day of , 19 , from A. B. for the use of the plaintiff [If received at several times or from more
than one person, say “as follows,” and insert dates, names, and amounts].

No. 31.--CLAIM ON AN ACCOUNT STATED.
THE plaintiff claims £ on an account stated between the plaintiff and the defendant on the
day of , 19 [when the defendant gave the plaintiff an I.O.U. for that sum].

No. 32.--CLAIM ON A PROMISSORY NOTE (PAYEE v. MAKER).
THE plaintiff claims £ , the amount of a promissory note dated the day of ,
19 , and made by the defendant and payable to the plaintiff on demand [or months
after date], and which the defendant has not paid, which note was in the words and figures following
[Insert copy of note]; and the plaintiff claims the further sum of £ for interest, at the rate of
per centum per annum, down to the date of judgment.

No. 33.--CLAIM ON A PROMISSORY NOTE (INDORSEE v. MAKER).
THE plaintiff claims £ as the indorsee of a promissory note for £ , dated the
day of , 19 , made by the defendant, and payable on demand [or months after date]
to A. B. or order, and endorsed to the plaintiff, and which the defendant has not paid, and which note
was in the words and figures following [insert copy of note]; and the plaintiff claims the further sum
of £ for interest, at the rate of per centum per annum, down to the date of judgment.

No. 34.--CLAIM ON A PROMISSORY NOTE (INDORSEE v. INDORSER).
THE plaintiff claims £ as the indorsee of a promissory note for £ , dated the
day of , 19 , made by A. B., and payable on demand [or months after date] to
the defendant or order, who endorsed the same to the plaintiff, and which said note was dishonoured
on presentment, and notice of such dishonour was given to the defendant, and which said note was in
the words and figures following [Insert copy of note]; and the plaintiff claims the further sum of
£ for interest, at the rate of per centum per annum, down to the date of judgment.

No. 35.--CLAIM ON A DISHONOURED CHEQUE.
THE plaintiff claims £ , the amount of a cheque drawn by the defendant on the Bank of
at , payable to the plaintiff or bearer, and dishonoured on presentment; and
the plaintiff claims the further sum of £ for interest, at the rate of per centum per
annum, down to the date of judgment.