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<br />,~ __. _ ~-- <br />INSTRZICTtONS: <br /> (rj If ike ben u ctaiaeud by a fasn or car oration, sta4 hest that a~mtt u a menabrr of the ~ or his <br /> of~inat ca¢acsty ns the rorgoratian. <br /> - Cal: State here mhather verbal or mritten cenbact. If mtittew, attach copy, os lien it void. <br /> i3) °~`~~' %" "Corextnertr'm~ •, ,•AtteratimE;' os "7tspav," at t!u rate may bc. <br /> C4) Hen insert correct legal demiption of lard. <br /> C3j If fhe tabor and rnatsriat mere frrsreished the contractor and not ttu omxar dazct, s#att "tkat. <br /> <br />_ vase ehe coutsactor on sad bnitding and actnsg for tha owner:' - <br /> <br />~ t6) If xote has bean given, saq "said ansomt us a omissory note, a copy of said note <br />` <br />~ <br />`~ <br /> , EshrZrit <br />d ~ <br />bang hereto attached and _~rarked ~ <br /> <br /> ' <br /> 4 <br />-.. <br />'~ <br /> ~ <br /> ~ - <br />- .. <br /> <br />\ £ - <br />Y <br />~ <br /> _ _ l <br /> <br /> lye <br />' <br /> ~! 'l ~~ 1if ,S 8 Iu ~ <br />~ tk. <br /> <br /> m w~~ 9 aL o -- w ' <br /> -~ i ~z~aY <br /> m a rz <br /> s ~ ro 0 <br /> W fJr V ~ <br />0 <br />l <br />