|(Please fill in address and nearby spots)|
|(Please fill in hours)|
|5555 555 5555|
|(Names of owners/proprietors here)|
|(Date, i.e. DD-MM-YYYY)|
|(Type of payment)|
Then, put whatever you want down here! Note that http://local.google.com is sometimes a good and easy place to find times/phone. Better yet, look them up in the phone book, and ask them. Remove the fields you don't fill out — or even better, look up or call them for the missing information!