原告：_________________________________________________________

    所在地址：_____________________________________________________

    法定代表人（或代表人）：________________________________________

    职 务：______________ 电 话：_________________

    企业性质：_____________________ 工商登记核准号：________________

    经营范围和方式____________________________

    开户银行：_________________________ 账号：_____________________

    被告：_________________________________________________________

    所在地址：_____________________________________________________

    案由：_________________________________________________________

    诉讼请求：_____________________________________________________

    事实与理由：___________________________________________________

    ______________________________________________________________

    _____________________________________________

    证据和证据来源，证人姓名和住址：_______________________________

    此致

    __________人民法院

    起诉人：

    年 月 日

    附：本诉状副本___份