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This Summons, [or Note of Suspension, or Note of Suspension and Interdict, or Note of Suspension and Liberation, . . . F2 ] executed [or intimated] by me [insert Name], Messenger at Arms, against [ or to] [ insert Name or Names], Defender [or Defenders, or Respondent or Respondents] [state whether personally or otherwise], in Presence of [insert Name and Designation of Witness], this Day of Eighteen hundred and Years.

[Signature of Messenger.]

C.D.,Witness.