In the District Court of

No.                       of 19            .

Between

A. B.,

Plaintiff,

and

C. D.,

Defendant.

Take notice that the Plaintiff accepts the sum of £                       paid by the Defendant (C.D.) into Court in satisfaction of the claim in respect of which it was paid in (and abandons his other claims in this action).

Dated the                       day of                                  , 19            .

X.Y., Plaintiff's Advocate.

To Mr. P.Q., advocate for the Defendant C.D. (and Mr. R.S., advocate for the Defendant E.F.).

Note.-Words which are inapplicable should be deleted.