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/ , <br /> • <br /> t , <br /> ' . 'i <br /> • <br /> t 4 INSTRIIcTIONS: <br /> {7 , , (i) If the lien is claimed by 4 frrns ar corporation, state here that : afant isa mcnrber of The fir's& or his <br /> ;44,4 offtcur1 capacity in the corporation. <br /> , (x) Stata bore evhet ter verbal ' or written. contract. If written;` attach copy, or lien is void. <br /> ,i (3) "E' „ -„ „ <br /> rCGtiDtr, Conslructtoa, + rllttration, or ` Repair, as the can Wray be. <br /> y (q) Here, insert correct kgandescription of .land. <br /> ^ x (3) If the labor and rttaterial were furnished the contractor and not the: owner direct, state "that It <br /> " ', was file contractor as said building and acting . for the ' awner.,, <br /> (6) 1 f note has ,beest pities, . say . said amount it further evidenced by a promissory note, a copy of said !tote <br /> "s" being •hereto attached (Intl 'Invited 'Exhibit 111." <br /> r " nkE r . <br /> o <br /> c iti 'pp iti t c ;,uM. <br /> t Lds7 }�ytai. .x k <br /> 7 ` c <br /> 8§t <br /> tFr 1 <br /> kY <br /> F M1 <br /> Swf <br /> it <br /> . <br /> • <br /> i t <br /> Sf4 <br /> - <br /> t� 7� <br /> Cy " <br /> i <br /> • <br /> 31 <br /> • <br /> • <br /> 1 <br /> 10: al <br /> 1 - <br /> r.. . , <br /> ..; <br /> a. <br /> • <br /> i • <br /> �� r <br /> i t <br /> \\ ,, S``$ . <br /> { 07 j li` , `� <br /> i L 4 ILL.. , 44-11j" ; ;t •., <br /> Lfbit-hd <br /> . o> Li• - <br /> . 0 . c:1 11) E7 Pi ' CO . <br /> X51. (L ' ft[ ci ( Nk <br /> Q <br /> \ , .ii <br />