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<br />INSTRUCTIONS: <br />(r) If the lien is claimed by a firm or corporation, state here that affiant is a member of the firm or his <br />official capacity in the corporation. <br />(2) State here whether verbal or written contract. If written, attach COp)', or lien is void. <br />(3) "Erection," "Construction," "Alteration." or "Repair." as the case may be. <br />(4) Here insert correct legal description of land. <br />(5) If the labor and material were furnished the contractor and not the owner direct, state "thaL............... <br />was the contractor on said building and acting for the owner." <br />(6) If note has been given, say "said amount is further evidenced by a promissory note, a copy of said note. I <br />being hereto attached afld marked 'Exhibit B'." ~ ~ <br /> <br /> <br />-c\ ~,~ <br />~~ ~ <br />~~~~ <br />o J <br /> <br />'1~~ <br />'S~ (' ~~ <br />\J /.' <br /> <br />.--- <br /> <br />....r <br />~--I <br /> <br />I <br /> <br />I <br />fc <br />r' <br />t <br />,. <br />r: <br />r <br />~, <br />i <br /> <br />~ <br />~ <br /> <br />o <br />Z <.0 <br />i ~t\~I~ <br />~ ~ j~ ~ <br />.. M 5 ~ .g z: \.L <br />CJ C C OiL 0: <br />I :::~~o>- <br />"i <.? 0 Z ILl I- <br />",00 l-Z <br />11/ <! ;:) <br />'CCO 1-0 <br />.u cno <br /> <br />r.,") <br />(/) <br /> <br />L <br /> <br />L'"l <br /> <br />) <br />.....:1 if <br />~, t <br />,,;,J ~ <br />'Ii ~ <br />\ c <br />~ l: <br />V\n <br /> <br />x= <br />0.... <br /> <br />co <br />C"U <br /> <br />::r:: <br />c:;c <br />--;) <br /> <br />~ <br />co <br />... <br /> <br /> <br />r- <br /> <br />~ <br />