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INSTRUCTIONS: <br />(r) If She diem is claimed by a fsrm or corporation, state here tkaE affiant is a member of the firm or his <br />ofJteial eapatity in the corporative, <br />(z) State here scslsether verbal or utri#ten contract. If uwiiten, attaeiz copy, or lien is void. <br />(3) "Erection,° "Construction," "fllteratinn," ar "Repair," as She case may be. <br />~¢) 'lftTr`ins~rE"torrett legal descsiption of land. <br />z- (S) l~`'the7abor anil'matariad uxre furnished the contractor and not the owner direct, state "that._.........__.... <br />ores Ehe contractos ox said building and acting for the ownar.» <br />ib) If note has been given, say "said amount is further erridenced by a promissory notr,, a copy of said note <br />being hereto attached and marked 'Exhibit B':' <br /> <br /> <br /> f~ ?a 'i <br /> 'i1 `n _ <br /> i J <br />a. <br /> <br /> '''' 'v <br /> e ~,,, <br /> 1 a ~ ~ <br /> 4j <br /> b <br /> s <br />f L' <br />0 <br /> f' _ _ _ 4 <br />_ +, <br /> ~ ~ . ' <br /> tt <br />j <br />i~ ~ <br />~ € <br /> i <br />~ ~ a <br />~ ~; <br />~ ' <br />b <br /> + ~ ~ <br /> ~ ~ ~ b <br />"~ <br />. <br />4 <br /> y <br />~ ~ <br /> ~ ` <br /> - +~S C <br />