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.,...: <br />IIVSTRL%C1'rOiv Sr <br />(ri If 'then lien is ~larared 'by a fsrrn or corporation,. state here that a~'rdnt u a member of the- time or hzs <br />- oLTicia! crpacit ~. in the cdrparatiore <br />~zj State here :whether verbrl m^ writfex eorttzaet. ff;~ritten, aitach ropy,. ar`lien is vaid. <br />(~) "Erection," ' Con+tr ectwn "_4lteratioa;" or "Repair," ns the cese n2a1~ ba. <br />1¢) Here insert correct hgai d rcri¢txon cf laNd. <br />(j) If the Icbor and materxad .sere furniched the eantrartor and not the oumzr direct, state °that. __... <br />xaas the contractor nx said building and act4ng for tha ownzr_" <br />l0) 7f note iaas been ni/en, guy ~`satid mnount s further cvidanccd by a promissory note, a mpy of said note <br />_ being hrreto atiached m:d ma~I;ed 'Exhibit ;;':' <br />