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<br />I <br /> <br />INSTRUCTIONS: <br />(I) If the lien is claimed by a firm or corporation, s tate here that affiant is a member of the firm or his <br />official capacity in the corporation. <br />(2) State here whether verbal orwrittetl co"tract. If written, attach copy, or lien is void. <br />(3) "Erection," "Construction," "Alteration," or "Repair," as the case ffl(JY be. <br />(4) Here iruerl correct legal descriptio" of land. . <br />(5) If the labOr alld material, were f"",iSIsed tls,e COlI tractor and 7IOttheowner dimt, state "thaLm...........,.. <br />was tlse coistractor 1m, said bNilding iJMacting for the pwner." , <br />(6) If 7IOtehas been given, say "saidamalltl', is fllrthermdencedby a prolHissory "ote, a copy of said note <br />being hereto attached and marked 'ExhibitB'." <br /> <br />r <br /> <br /> <br /> <br />91 <br />~ <br /> <br />o <br />z <br />.l~ <br />'1:;,' ,'. ,', <br />. ........ <br />, -- <br /> <br />t~ '-.;;<~ <br />U'~ <br /> <br />IS !ll2-, <br /> <br />- I! :t.:' -" <br />.' a~ z','~ .- <br />! -- '. :-~'. ---~ <br />. .~- <br />~ .... <br />I <br />10 <br /> <br /> <br />.'_ s <br /> <br />G :--~ <br /> <br />~:....: <br /> <br />.'--- -~~ <br />~c <br /><f) <.:> <br /> <br />= ~\ <br />-, <br /> '- " - <br />r- v, <br /> - <br /> '- <br />.~-... - <br /> ~ <br /> - <br /> - <br />"-,0: - <br />cv-I <br />V-J <br />l~..._': .. <br />-, ~, <br />r-- 'J '~ <br />0::1 <br />.. <br /> <br />-~ <br />~ <br />-' ~ <br />~." <br />'i ~ <br /> <br />~ ~ <br />,') ~ <br />l\~ <br />{ ~ <br />~ ~ <br />ct~ <br />~~ <br />" <br /> <br /> <br /> <br />..u,.:Jm <br />