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<br />r <br />\?\........ <br />~\ <br />) <br />\CQ <br /> <br />INSTRUCTIONS: <br />(1) If the lien is daimed by a firm or corporation, state here that affiant is a member oj the firm or his <br />official capacity in the corporation. <br />(7) St.mh~n whetlU!r verbitl or written contract. If written, attach copy, or lien is void. <br />(J) "Erecti<Jn," "Constrru:tion," "Alteration," or "Repair:' as the case may be. <br />r 4) Herd1lSert correct legit! description of land. <br />r 5) If. the1<Jbor alld material were. furnished the contractor and not the owner direct, state "thaL..,.....nJn.. <br />Was the con/rlletor on said building and actifig fo:' the owner." <br />(6) IffWtehasbeen git'ff!, say ".raid am",...t;s further evidenced bya promissory note, a copy ofsaittllote" <br />being hereto at/lUlled .and marked '{!.xhibit B'." <br /> <br />co <br /> <br />~.,j.'.. <br />'~ <br />~~'.. <br />~."'.'h.~~....~.~:i.........^'..... <br />\'\. ~,~ <br />~... ~(/0 .... <br />~0&".".~..'~. <br />~ \.\ r,..' '0 <br />J"" ,), <br /> <br />~ <br />1 <br />~ <br />~ <br /> <br /> <br />d <br />Z <br />l a\J~~J~ <br />o (0- ,J,j.~~ <br />~ ~~~~.~ .~ 11 <br /> <br />'"tI '.. n-':::r..,~ = <br />~ tC <br />~(T) ~~-:: <br />woo. <br /> <br />~ <br />&on <br /> <br />} <br />~ if) <br /> <br />en <br /> <br />= <br />cr <br /> <br />IJ..,} L.,- <br />,:"..:, L..l <br />\'~-; <br /> <br />"'" <br />=> <br />= <br /> <br />\'.:-... <br />...,;.J <br />r'-., : ~ u:: <br />\ -" <br />\./\ <br /> <br />!.: C <br /> <br />..... <br />= <br /> <br />.\..-,-;, ~ <br /> <br />L <br />