Fill and Sign the Nebraska Termination Form

NOTICE OF TERMINATION OF NOTICE OF COMMENCEMENT- INDIVIDUAL THE UNDERSIGNED hereby informs all concerned that the undersigned will TERMINATE that certain Notice of Commencement dated _____ day of _________________ , 20 _____ , that is recorded in Official Record Book __________ , Page __________ , of the Public Records of _________________ County, Nebraska, and in accordance with NRS § 52-146, the following information is provided: 1. The date and recording information concerning the Notice of Commencement being terminated is as described above. 2. A copy of the Notice of Commencement is attached hereto and all information contained therein is hereby expressly incorporated into this Notice of Termination. 3. The Notice of Commencement shall be terminated as of _____ day of ______________ , 20 _____ (w hich date may not be earlier than thirty (30) days after the notice of termination is recorded). 4. The real estate being or intended to be improved or directly benefited is described as: ______________________________________________________________________________ _____________________________________________________________________________ . 5. The undersigned Contracting Owner’s a. Name and address: _____________________________________________________________________________ . b. Interest in real estate: ___________________________________________ . c. Name and address of fee simple titleholder (if other than contracting owner): 6. This Notice of Termination is effective as to all property described in the Notice of Commencement unless a legal description is set forth below this paragraph (in which case the termination is effective only as to the property described). ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________ . Signature of Owner _________________________ Owner's Name _____ ________________________ Owner's Address _____ ______________________ Notice of Termination of Notice of Commencement Page 1 of 2 State of Nebraska County of __________________ The foregoing instrument was acknowledged before me this __________________ (date) by ______________________________ (name of person). Signature       Title or Rank Serial Number, if any:             Type or Print Name Certificate of Service I,       , hereby certify that I have delivered this day a true and attested copy of the foregoing to all claimants who have requested that the owner notify them of the recording of a notice of termination : ( ) Actual Delivery to the person to be served. ( ) Mailing a true and correct copy of same by registered or certified U.S. mail, with postage prepaid, or by overnight or second-day delivery with evidence of delivery. ( ) If service cannot be made by the above methods, by posting on the premises. Signature Prepared by and Return to: (name and address)                         Notice of Termination of Notice of Commencement Page 2 of 2