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~. <br />1€ <br />INSTRUCTIONS: <br />~ ~' If the lien is clainsed by a firm or corporation, state here that ajfsant u a member-of- the firm or hit <br />~ -'' o Ytjt eK,tlse corporation. <br />~i ! ~ t€~ d}ltier verbal or written conisnrt. If written, attack copy, or Gen is void. <br />(3) Lractiosi~ ~~fi3isaclion,» "fllteration," or "Repair" w the case may be. <br />(¢) Hereinsert correct degal descriptionof land. <br />f5), If the labor and malaria! were furnished the contractor and not the owner direct, stale "that_.._.........._ <br />was the contractor on said building and acting for the owner." <br />- ~ - (6) ~ ff state i3ar been given, say "said amount is furtker evidenced by a pramusory awls, a copy afraid Hate <br />being Jsereto attacked and marked `Exhibi! B :" <br />., <br />i <br />=' ~ \'' <br />~`t~r. <br />VE <br /> <br />_ .., '' >s <br />~ ~ @' _ r <br /> <br />~ ~~ <br />~i ~ ~ <br />; ~ ._ <br />~ <br />--44LL22 <br />~ ~ $ ~ ~:~ i:s <br />~ <br />LL <br /> <br />~~ <br />~ <br /> <br />l <br />~~ "". <br />dz7',C:r <br /> <br />i. i i <br />i <br />~~ i <br />1~ ~ i ~ <br />OGq <br />~' <br />-i <br />~; <br />i~ ~ <br />~' <br />~f "~ o <br />ti <br /> <br />- <br /> <br />~ ,., <br />s <br />'v <br />ii <br />i .- --, - a, ~ ° <br />~ n <br />„ s <br />., <br />~' ~ c <br /> <br />~ 9 <br />1~ ~ tl <br /> <br /> <br />1~ '° ~ <br />~ a <br />t( <br />~ o ~ <br />I <br /> _ 1 <br />~ ~ ~ <br /> ;~ <br />.k <br />~+ <br />. <br />~`"` <br />t~ <br />i., k <br />~~ <br />~_~ <br />