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Notice of Right to Assert a Lien Page 1 of 2 NOTICE OF RIGHT TO ASSERT A LIEN- INDIVIDUAL (NRS § 52-135(1)) STATE OF NEBRASKACOUNTY OF ___________________THE UNDERSIGNED, who has entered into a contract under which he or she may claim a lien under the Nebraska Construction Lien Act hereby gives notice of the right to assert a lien to __________________________________, the contracting owner, and in accordance with NRS § 52-135, states the following:1. This is a notice of a right to assert a lien against real estate for services or materials furnished in connection with improvement of the real estate.2.The owner or others may send communications to __________________________________, claimant at the following address: __________________________________________________________________ _________________________________________________________________.3.The claimant contracted with ________________________________ whose address is: ___________________________________________________________________________________________________________________________________.4.The lien is claimed against or may be claimed against _____________________________, the owner.5.The following is a general description of the services or materials provided or to be provided:__________________________________________________________________ _________________________________________________________________.6.The real estate against which the lien is or may be claimed is sufficiently described and identified as: ___________________________________________________________________________________________________________________________________. Notice of Right to Assert a Lien Page 2 of 27. The undersigned claimant is entitled to record a lien.8.The following amount is the amount unpaid to the claimant for services or materials, whether or not due, or if no amount is fixed by the contract, the following is a good faith estimate of the amount designated as an estimate: __________________________________________________________________ _________________________________________________________________. Warning. If you did not contract with the person giving this notice, any future payments you make in connection with this project may subject you to double liability. This the _____ day of _____________ , 20______.__________________________________Signature of Lien Holder__________________________________Type or Print NameState of NebraskaCounty of __________________The foregoing instrument was acknowledged before me this __________________ (date) by ______________________________ (name of person).Signature Title or RankSerial Number, if any: Type or Print NamePrepared by and Return to: (name and address)