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�; ;. <br />.�, : ' '; _ <br />� „ � �� y� <br />� � <br /> I <br /> INSTRUCTIONS: ' <br /> (t) /( the lien is clai�ued by a fir�n ar corporation, state liese �hat a�ant is a rnemLer of Nie jr»� or his ' <br /> o((icial capacity in tf�e corparatian. <br /> (a) Stafe Gore 2c�hether verbn! or written coi�tracl. 1/ u�ritten, uttach ca�y, or lien u void. , <br /> (3) " » .� „ „ „ , » <br /> Erectian, Construction, fllterafion, or ' Repuir, as t{ie case ��tay be.. <br /> � (q) , Here insert correcflegal description of land. � <br /> ; , . (5)-1f tl�e la6or and rnaterial were f:anished tke coritractor a�id not dte owner direct, .rtate "tlmt....... ......._ <br /> • znas !Ae contractor an said bsilding m�d acting for the ozvncr." <br /> t (6) I f note lias Leeri give�i, say "said a�rtotrnt is f�irther eeridenced Gy a prornissory note, a caQy of said nole <br /> Gci�ig- hercto attuched a�id t+�arked `Esliibit !3:" <br /> i . : <br /> -X <br /> <� , <br /> ;<: <br /> ,q . . . . . . . . . . . <br /> ,_. . . . . . . . . . . � . . . . . . . . <br /> � . . . .. . . . . � . . <br /> �Y <br /> � <br /> :s <br /> � , <br /> k <br /> .a <br /> _ r <br /> .: <br /> rt� _ ' <br /> ;i : <br /> : s ; <br /> � '' <br /> , ,; <br /> ,' i <br /> � \ <br /> f ! ci, . 7 , <br /> 4�_i . � 1 . . � . � . � . . . _ . . <br /> , . + <br /> �, � <br /> � r� q . . . . � - . <br /> ; � � t � ^ .� <br /> � C'� � M �. ; �. <br /> ' �� �" � , ! �"a _ � c 4 : . <br /> � O nr'� - �'- `;� i �' <br /> � � � <br /> o O g n � y., : : ` i : . <br /> u � `m� t._ c� c � <br /> ti C � L �C r`� N '� ` � . . <br /> � � L � <br /> � „� � . 2C ii� (_. J .� lc . <br /> �: . . � 1� F— ' r� (`��'' ` . <br /> N � p \/���v . . <br /> c�� . i � - N U � . <br /> w <br /> � i <br /> 'e i <br /> ' i <br /> : � � � <br /> ( � ' ^V ' ' <br /> ' ; I ' Ii �, ; ` : .� �. 1 � <br /> � � o � � � '• �, � z <br /> . � I ` i C� : y. �� z, ^ . . <br /> ' . �,� ^ G '� � o ` !�Y '� . <br /> �. b d : L1 I � \ b <br /> _ . . � , � ti x c' — ° ' <br /> . 1 ;, . I � �. L i .� o <br /> f/� . I! O !. � � ^ � � . , �rY.� . <br /> 1 U C� ` '� 'n F '�tr` . <br /> � . � . y � . � ' � - ` ' . � N 3. . <br /> . . �r�[' . N 'y G � `� ` a • � i' <br /> . 4i � O _ ~ � �(� U . . � . <br /> i. � :'� � �i <br /> � ' y `u \ C <br />� � � 'J� •'V�` 1 ` � � . � . <br /> . . t I i ,O� b y � y . , <br />� I� � ;� v � � ,.��� : ,G <br /> z� � '~ � ': �4 <br />`= � � <br />�' , � i� � . . � � � �. � . / . <br />� i � � <br />-�� <br />�� <br />