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IAISTRUCTIONS: <br />(tj 1/ the lien is edairned Ly u firm or corporaNan, state here thct ajfiant is a member of the fame or his <br />oQiciad ca¢acity do the farporatiDn. <br />(z} State here whither verbal br mnttex fDntract. If wntten, attach co¢y, or lien is void. <br />(3} ''Eretfirm," "Canstructiox," "Alteration," or "Reprir" as the case may be. <br />(~} Here ixaert correct lagad descriptiax of land. <br />!Sj If the labor and materiel acure fxrnislFed the contractor and not G5e o^.ener direct, state "that .................. <br />was thu eaxhactor on said bnitdrng and acting! for tie ozunar." <br />Cd} lj rote has be€n given, say "said amount is jurtiter ~^videxced by a promissory note, u tD¢y of said note <br />bti~g heretD attached and marked 'Fxhs3it $ :•' <br />3 <br />i .... .... ..... <br />Sro~.,~ ;-... <br /> ~ ~4 <br /> <br /> <br /> '~" `~ ; ~t <br /> <br /> <br />Q <br />~ ~C <br /> ~`F'~ <br />• ~ n. <br />r.. <br />~ <br />r <br /> <br /># +~, *~ <br />; <br /> <br /> .. <br />