IN THE COURT OF CIVIL JUDGE …………..

                                                                                                                                                               SUIT NO. …………………………………

Address of Plaintiff ……………………………………………………………………....  Plaintiff

                                                                          Vs.………………..

Address of Respondent…………………………………………………………...…... Respondent

NOTICE UNDER ORDER XII RULE 4 OF CPC TO ADMIT FACTS

Take notice that the plaintiff [or defendant] in this suit requires the defendant [or plaintiff to admit, for the purposes of this suit only, the several facts respectively hereunder specified; and the defendant [or plaintiff] is hereby required, within six days from the service of this notice, to admit the said several facts, saving all just exceptions to the admissibility of such facts as evidence in this suit.

1. H. pleader for [agent] for plaintiff [or defendant].

To E. F., pleader [or agent] for defendant [or plaintiff].

The facts, the admission of which is required, are: -

(state those facts which require admission)