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t <br />INSTRUCTIONS: <br />(rJ if the lien is claimed by a firnc or corporation, state here t?:at aj]iant is a member of the ;irnt or /tis <br />official rapacity in the corporation. <br />(a) State here whether verbal or written contrcct. If xerritten, attach copy, or hen is void. <br />(3) "£rectivn," "Construction," "Alteration," or "Repair," as the case ntay be. <br />(¢) Ziere insert correct degad description of land. <br />(5) If the labor and material were fnrnisked tke contractor and not ilte owner direct, state "that .................. <br />was the contractor on said building and ;utir.~ for the oxtmer." <br />(6) If note has been gi¢~en, say "said a}rtozrnt is iurrher r~idenced by a promissory note, a copy of said note <br />being hereto attacked and marked `ExJ:ibit B"' <br />t,i~ <br />~e <br />l~~ <br />~ 4'} G7 <br />h ~~ <br />a ~ ~ <br />Z ~~` !ice c.-. <br />~ ~ ~~y~~ <br />'' C <br />v O <br />f~ `-t--` <br />m <br />c <br />>~ <br />c. <br />~~ _F . <br />3 <br />w <br />~~ <br />r <br />~~^. <br />i ~~ <br />~: <br />~: <br />l ~~' <br />