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r <br />INSTRUCTIONS: <br />(z) If the lien is claimed by a firm or corporatian, state here that affiant is a member of the frrm or his <br />official capacity in the corporation. <br />(a) State here wkether verbal or written contract. If writtem, attach, copy, or lien is void. <br />` !3) "l:rectio»," "Construction," "Alteration," or "Repair;' as the case may be. <br />(¢ j Here insert corral-legal description of land. <br />(5J If the labor and material were fusnished the contractor and not the owner direct, state "that..._ ............. <br />ufas the contractor an said building and acting for tke owner." <br />(6) If note has been given, say "said amount is further evidenced by a promissory note, a copy of said note <br />being hereto attached and marked 'Exhibit B'." <br /> c~ <br /> <br /> <br />~, C~ <br />C <br />` ~ _ C ~ eJ t <br />~ p C <br /> <br />~ <br />I t <br /> ~ <br />~ ~ ~ ~ y ~ <br /> <br />O <br />~ ~ <br />~ th <br /> d -~ V G r ~q` SV <br /> ` O , <br />iri 'a. ' c3 c~ <br /> <br />l <br />