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<br /> <br />INSTRUCTIONS: <br />(I) Ifth~ lien is claimed by a jiYm or cMPoration, state here that alJiant is " member of tlu firm or his <br />ofJkial copacity in the corporatiow. <br />'(izi)'SfIfJ;i'ltHe'iilhether'lltfbal or-Mitt#lcontract Ifwritfii(attach copy, or lien is void. <br />(j)-. (:Ere~/' !rC8fl.stf"'tf.t:t:;oif;.>7.u~4U~tion/~ or uR!!/1f!it"/~ as theocase ~ be. <br />(41E!~eiffs~ correctkgt;ddescription of land. <br />(5) if the lab".. and material' fUete jurnislud the contractor and not the own" direct, state "tli(lt",~,,""..m.' <br />. cflliJ$ the' clJtftriUlor 011 st1id btmdillg and a:ctillg for the owner." <br />(4J'.If.trMe. /m$. bu#fJ~;'~" "said. ombrmt isf1lt'ther evidenced' by a promissory note; a copy 'af sauhlotlf <br />. :~h"eto.attlKlud;'antJ lIUIrked 'Exhibit Ji'." <br /> <br />1 . <br />1 <br />J' <br /> <br /> <br />