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;. ,~ . <br />INSTRUCTIONS: <br />(r) /f ttu lien is claimed by a firm or corporation, slats here that aQant u a member of the fines or his <br />bffteiCt Capacity in the COrpOr6lt(M{, - <br />(z) State here tohethsr txrbal or written eonNact. If written, attock copy, ar lice is void.. <br />(,I) "Erection,» "Constskceion," "Atterabion; , or "Repair" as ehe cars nnty be. <br />(¢) Here insert correct legal description of land. <br />(5) ff the tabor-and maitriol ware furnished the contractor and nat. the owner direct; stars "that..:..;.....: <br />war tke contractor on said building and actixg for the aunrsr." <br />(6) If -note has been given, say "said mnrount u fustktr evidenced by a promissory no#e, a'co¢y of said note <br />being hereto attached and marked 'Exhibit B'." <br /> ~ <br />N t/9 t <br />•r1 F <br /> _ <br />~ <br /> <br />R <br />4 <br />~ <br />- t- <br /> .., <br />~ C - . <br />~ <br />_ _ <br /> _ <br />~' <br />N C~ <br />-~ - <br />~ -~ <br /> C1 <br />~+ 1. <br />,~w" <br />//1 G! $ -'yam ~ w <br />• ~ <br />~`"' V~ <br />W <br /> W ~ <br />• <br />