II.

That on the ment by the plaintiff of the premium of

day of, in consideration of the pay

dollars, the defendant made its policy of insurance in writing to plaintiff, a copy of which is annexed to this complaint, marked exhibit "A," and is made a part of this complaint;

III.

That at the time of making said policy the plaintiff had an interest in the property insured, as the owner [or mortgagee] thereof, to an amount exceeding the sum of

dollars, and such interest existed when said property was destroyed by fire, as hereinafter stated;

IV.

That on the

day of

said [state the property which was insured against fire] was [or were] totally destroyed [or were damaged and in part destroyed] by fire, to the loss of plaintiff in the sum of -dollars, and said fire did not happen by either or any of the following causes named in said policy, namely: [State the causes excepted in the policy.].

V.

That the plaintiff has duly performed all the conditions of said policy of insurance on his part, and on the

day of

dol

gave to the defendant notice and proof of said fire and loss, and demanded from defendant payment of said sum of lars, the amount of said loss;

If there be a provision in the policy as to arbitration, plaintiff should allege facts showing that by reason of no fault or neglect on his part, no arbitration was had.

VI.

That the defendant has not paid said sum of

dollars,

the amount of said loss, nor any part thereof, and the whole thereof is unpaid.

WHEREFORE plaintiff demands judgment against defendant for the sum of dollars, and interest thereon from the

day of

—, and plaintiff's costs of suit.

GH,

Attorney for Plaintiff.

FORM NO. 24.

COMPLAINT ON INSURANCE ON LIFE.

[Name of Court.]

Plaintiff complains and alleges:

I.

That the defendant was at all of the times in this complaint mentioned, and is a corporation created, organized and existing under the laws of the state of

II.

;

That on the day of, in consideration of the payment by one M N to the defendant, of the premium of — dollars, the defendant made its policy of insurance in writing to said M N, a copy of which policy is hereto annexed, marked exhibit "A," and is made a part of this complaint;

III.

That said M N duly performed all the conditions of said policy on his part;

IV.
at

in the state of

That on the day of said M N died, which death was not caused by either or any of the following causes: [State the causes excepted in the policy.]

That said M N left a will in which plaintiff was named as

sole executor, and after his death, and on the

day of said will was admitted to probate by the order and decree of the Superior Court of the state of California in the county of duly given and made, and said court by its order duly given and made, appointed plaintiff the executor of said will, and granted to him letters testamentary thereon, and he qualified as such executor; and thereafter and on the day of letters testamentary were issued to him as such executor, and he has been such executor ever since;

V.

That on the

day of

notice and proof were given to the defendant of the death of said M N, and the cause of such death and plaintiff, before this action, gave proof to defendant that plaintiff was the executor of the will of said decedent, and demanded from the defendant on the - said sum of

day of

dollars, the amount of said insurance money, but the defendant has not paid the same nor any part thereof, and the whole thereof is due and unpaid.

WHEREFORE plaintiff demands judgment against defendant for said sum of dollars, and interest thereon from said

- day of, and plaintiff's costs of suit.

GH,

Attorney for Plaintiff.

FORM NO. 25.

COMPLAINT ON A VALUED POLICY ON SHIP.

[Name of Court.]

Plaintiff complains and alleges:

I.

That the defendant was at all the times hereinafter mentioned, and is a corporation created, organized and existing under the laws of the state of

II.

That on the

day of

of

;

in' consideration of the premium dollars paid to the defendant by the plaintiff, the defendant made to the plaintiff a policy of insurance in writing, of which the following is a copy: [Insert copy.]

III.

That said ship was then lying at the port of

voyage from said port to

in

;

- for a

IV.

That on the port of

the said ship sailed from said on the voyage described in said policy, and while proceeding thereon was by the perils of the sea wrecked and totally lost; [or was burned and totally destroyed]

V.

That the plaintiff was at the time of the risk, and thereafter, until said loss, the owner of said ship, and was interested therein to an amount exceeding dollars, namely: in the

sum of

dollars, which was the value of said ship;

VI.

That plaintiff duly performed all of the conditions of said policy on his part, and after said loss and destruction of said ship he gave, on the day of to the defendant, notice and proof of said loss and destruction, and demanded of defendant said sum of dollars, the amount of said insurance money; but the defendant has not paid said money, nor any part thereof, and the whole thereof is unpaid.

WHEREFORE plaintiff demands judgment against defendant for said sum of — dollars, and interest thereon from the — day of, and plaintiff's costs of suit.

That at all the times hereinafter mentioned the defendant was and now is a corporation created, organized and existing under the laws of

That on the

of

;

II.

day of, in consideration of the premium dollars paid to it by the plaintiff, the defendant made to plaintiff a policy of insurance in writing, of which the following is a copy: [Insert copy.]

III.

for

That the ship on which said insured property was laden [or was about to be laden] was then lying at the port of a voyage from said port to

in

IV.

;

That plaintiff was at the time of the commencement of the risk, and at the time of the loss hereinafter mentioned, the owner of, and interested in said insured property to an amount exceeddollars, and the value of said insured property which

ing

was laden on said ship was, when laden and until said loss,

dollars;

That on the

V.

day of

the said ship sailed from said

on the voyage described in the policy, and while proceed

ing thereon, all of. said insured property so laden on said ship was destroyed by the perils of the sea, to the loss of plaintiff of dollars;

VI.

That plaintiff duly performed all of the conditions of said policy on his part, and on the day of he gave to defendant notice and proof of said loss, and demanded of the defendant the sum of dollars, the amount of said insurance money, but the defendant has not paid the same, nor any part thereof, and the whole thereof is unpaid.

WHEREFORE plaintiff demands judgment against defendant for the sum of dollars, and interest thereon from the

sessed of the following described real estate, [describing it] and on said day of ——, and while plaintiff was so the owner and possessed of said real estate, a lease in writing thereof was made between plaintiff and one M N, of which lease the following is a copy: [Insert copy.]

II.

That by virtue of and under said lease the said M N entered into the possession of said demised property, and was possessed thereof as such lessee;