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<br /> INST.i4UCTIpNS: . ` , , .
<br /> (z) l} the lien ss clainsed by m �rm or corporation, state here that a�iant is ¢ snember of the farnro o! lais t " ' ' ' "`
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<br /> ojJ'usal capacoty in the corporation: � � �, ' ` � ; , � � ; , �
<br /> (z�-�s�ta2e here� suh�ther; verbal or urri,tten contracl. If written, attach copy, ' or Iien is void. �, � "� ���� �`,'rM �Y,
<br /> � s �¢mn �d� �iY% U'y aNM` xtFJh Sf 1 . �n4 �� � Is . n u ., , ! r ..
<br /> � (3 s4ructio"n, Alteration, or � Rep�ir, as the case ��ny be. � � ; � r � r ��3
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<br /> ��*'^�^}��If�t�ka�abos»vmdk��t rial ze!ere furnished the contractor afsd not the a:.�aser daxect slate � that._,....: � '� x�'� � `� x �� ' ` � ^;�' � ""� " �����
<br /> �.�'�,����� � le ul descn tson :o lccnd_
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<br /> , k was the ioner¢ttor on sasa! busldixy and nct:ng far'-, the. owner." , r �� ,� y F ' F`" ` � :` ,"" vf i �'�
<br /> � , {6� If note has been given, say "said amount is -furdher evideaced by a promissorynate, a copy o� said note r '"'
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