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<br />INSTRUCTIONS: <br />(r) If the lien {s claimed by a firm or corporation, st¢t¢ here that affront is a member of tks firm. or his. <br />offeeiat capacity in the corporation. <br />(zj Sta#e here mhether verbal ar writt¢n contract. 1 f u~rilten, attach copy, or lien is void. <br />- (~) "Ftaction,» "Construction;' ".Alteration,", ar "Repair,' as the case- may be. <br />(¢J Here insert correct legal description of land. <br />(5J !f the tabor and material were furnished the rantrartnr and not the owner direct, state "that.~__._._..._ <br />was the contractor on said building and acting for the owner." <br />(G) If note has been-given, say :`said avnount is further rvideared•bya proaxissor'ynote,aropyaf'said note` " <br />,..:~,4 being koreto atiarhed and marked 'F_zhibit ft':' <br />'r,` ~ _ <br /> <br /> <br />~, r-f <br /> <br />~` :u~ <br /> <br /> ~ <br />~ <br />,a . <br />~ <br />6i <br />~ ~ <br />~ <br />W ti. <br />C~ <br />