Form 43.2-A

Form of summons and backing in personal injury actions

[Insert the Royal Arms in Scotland]

(This space will contain the cause reference number assigned to the summons on being presented for signeting and registration)

IN THE COURT OF SESSION

SUMMONS

(Personal injuries action)

[A.B.] (designation, statement of any special capacity in which the pursuer is suing, and address), Pursuer

against

[C.D.] (designation, statement of any special capacity in which the defender is being sued, and address), Defender

Elizabeth II, by the Grace of God, of the United Kingdom of Great Britain and Northern Ireland and of Her other Realms and Territories, Queen, Head of the Commonwealth, Defender of the Faith, to [C.D.].

By this summons, the pursuer craves the Lords of our Council and Session to pronounce a decree against you in terms of the conclusions appended to this summons.   If you have any good reason why such decree should not be pronounced, you must enter appearance at the Office of Court, Court of Session, 2 Parliament Square, Edinburgh, EH1 1RQ, within three days after the date of the calling of the summons in court.   The summons shall not call in court earlier than (enter period of notice) days after it has been served on you.   Be warned that, if appearance is not entered on your behalf, the pursuer may obtain decree against you in your absence.

This summons is warrant for intimation to (name and address and reason for intimation as set out in the rule of the Rules of the Court of Session 1994 requiring intimation).

Given under our Signet at Edinburgh on (date)

(Signed)

(Name and address of or agent for pursuer)

[Back of first page]

Conclusions

FIRST.   For payment by the defender to the pursuer of the sum of (amount of sum in words and figures).

SECOND.   [enter only if a claim for provisional damages is sought in terms of rule 43.2(2)]   For payment by the defender of (enter amount in words and figures) of provisional damages.

THIRD.   For the expenses of the action.

Statement of claim

1.	The pursuer is (state designation, address, occupation and date of birth of pursuer).   [In an action arising out of the date of a relative state designation of the deceased and relation to the pursuer].

2.	The defender is (state designation, address and occupation of defender).

3.	The court has jurisdiction to hear this claim against the defender because (state briefly ground of jurisdiction).

4.	(State briefly the facts necessary to establish the claim).

5.	(State briefly the personal injuries suffered and the heads of claim.   Give names and addresses of medical practitioners and hospitals or other institutions in which the person injured received treatment).

6.	(State whether claim based on fault at common law or breach of statutory duty;  if breach of statutory duty, state provision of enactment).

IN RESPECT WHEREOF

(Signed)

Solicitor [or Agent] for the pursuer

(address and solicitor/agent’s reference number)

(Backing of summons)

(This space will contain the cause reference number assigned to the summons on being presented for signeting and registration)