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<br />INSTRUCTIONS: <br />(1) If the lien is claimed by a finn or corporation, s tate here that affiant is a member of the firtH or his <br />official capacity in the corporation. <br />. (2)'Stats:here whether verbal or written contract. If written, attach copy, or lien is '/Ioid. <br />(3) "Erection," "conslrvction," "Alteration," or "Repair," as the.c/!-SefH(JY be. <br />. (4) Here insert correct legal description of land, <br />(5) If the labor and ff\CIterial were fNmished the contractor and nottheoWfll!r direct, state "that.................. <br />> .' ., 'was the contractor on said bNilding and acting for the owner:; <br />. .{6}.lf note-has bem given, say "said aff\O",,' is fNrther wideflCea bya promissory note, e copy of said note <br />.. 'beinghersto attached. and tHtJrked 'Erhibit B'." <br /> <br />.~ <br />~ <br /> <br />!\.....,..~I',~"'.''''~.~....,..:>.'....~''"''-''t''!':.~_,,~.Jf'I:...i\il.' <br />~ U~:~.~A ~lt~, I';I~.?-l,$' ~~~,,., ~::-4.'" 'fijo (:r-n r <br />1'^.J2\~t~~~:~~:~~rt~~:tJ;E~,:J <br /> <br />\.. ~ \ <br /> <br />c <br /> <br />~ <br /> <br />'V <br /> <br /> <br />.~~~ <br />f~~~ <br />~ ~~~~ i <br />.~J~ ~ <br />'-.:, ~~ c::s <br /> <br />ci <br />Z <br /> <br />C <br />Gl <br />E <br />::s <br />~ <br /> <br />... <br />III <br /> <br />U) <br /> <br /> <br />~~ ~~~ <br />u) <br /> <br />C ~j <br />"- <br />r-l ~ ~ ::c <br />"'~'c;-l:- <br />-E=el.:._C <br />I ~tJ~ ~ !-- <br />CO S;::::) <br />CO ~g <br /> <br />=- <br /> <br />c:n <br /> <br />J ~ <br /> <br />~- <br />== <br /> <br />1 <br />!? <br />c <br />.... <br /> <br />= <br /> <br />'~ <br /> <br />LL <br />C <br /> <br /><..':l <br />= <br />c:;:: <br />0:> <br />;0 <br /> <br />C <br />1..: <br />~ ........",.{ c. <br /> <br />\../~ <br /> <br />L <br />