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<br />I ~! <br />! 1 <br />"t'-~..., <br /> <br />ISTRUCTION LIEN <br /> <br />Jacob North Printing Co., Inc., Lincoln, NE 68524 <br /> <br /> <br />';)~0 <br />\J) .~ <br />f-j G,JIS <br />alSo <br />~ q <br /><- "') <br />l7\ ~ "'" <br />~.1; ~ <br />,..).:It:r"" <br />.........' f7l <br />O(J ~ c.. <br />'") ~. <br />w <br /> <br />~ <br />.." <br />c: <br />2~~ <br />nCJ"l <br />~::r:: <br /> <br />nn <br />::J:> <br />m CJ"I <br />n::r:: <br />'" <br /> <br />N <br />S <br />S <br />{)"J <br />....l. <br />N <br />..f::>, <br />(0 <br />..f::>, <br /> <br />. <br />l) <br />o <br /> <br /> .--...:> <br /> <:;.-=> (') (fl <br /> c= 0--1 <br /> c..r-> <br /> ">~ c:~ <br /> CJ z-4 <br />~,~ .., -ir11 <br />c-:;l -<0 <br />N 0<1 <br />...., N <1:z: <br /> r :r:fTl <br />D ~OJ <br />rn --0 ,;;0 <br />rTJ ::3 r> <br />0 <br />(f) (J) <br /> N ;:><: <br /> :t> <br /> U1 ................ <br /> ..- (f) <br /> CI> <br /> <br />T" <br /> <br />2. <br /> <br />p.6. &r.t./ <br /> <br />3. <br /> <br />4. The name and address of the person with whom the claimant contracted is: <br /> <br />c.u..IJ ~ tv/2 . ~~~~ <br /> <br />~~o-. p,0.~l <br /> <br />5. ~=~ to~~:~:C:~::~:::::~J:~ =':.p=.::,:~ JP~~::f 1t;;~~~ ~ m <br />~t~~,:;;;;:~:;;:}~aJ4U?~ ~~'''' -e., b- <br /> <br />6. (Complete one of the following) <br />V The amount unpaid, whether due or not, to the claimant for the services or materials is $ 50".00 <br />~ The unpaid amount is not fixed by the contract, but a good faith estimate in the amount of $ <br /> <br />7. (Complete one of the following) <br />~The time the last services or materials were furnished was /:J. D~ ,.<04 r <br /> <br />~ The time the last services or materials were furnished has not yet occurred but is estimated to occur <br /> <br /> <br />Subscribed and sworn to before me this <br /> <br />J;. GENERAL NOTARY-Slale of Nebraska <br />SHIRLEY SCHLATTMANN <br />My Comm. Exp. Nov. 4, ~008 <br /> <br />, <br /> <br /> <br />,~ Otl~; <br /> <br />(52-147. See 52-148 for amendment; 52-149 for assignment; 52-137 for recording time; 52-154 for discharge or release). <br /> <br />I <br />_ ~~rrl~-~o-- <br /> <br />, ..L- <br />Rev. 9/:51 <br />