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<br />I <br /> <br />INSTRUCTIONS: <br />(1) 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 ffefe whether verbal or written contrlict. If written,. attach copy, or lien is vaW, <br />(3) ",Erection;" "ConstrftctifJn," "Alteration," or "Repoir," as the case may be. <br />(4) Here insert correct legal description of land. <br />(s) If the labor and material were furnished the contro<tor and not the owner direct, state "thal...""",,,,,,,., <br />'was the contractor on said building and acting for the owner." <br />(6) Ii note has been given, say. "said amount is further evidenced by a promissory note, a copy of said note <br />bllitiglureto<tttached and m<trked 'Exhibit B'." <br /> <br /> <br />