Fill and Sign the Notice of Completionindividual Form

Notice of Completion Page 1 of 2Prepared by, recording requested by and return to:Name: ___________________Company: ____________________Address: _____________________City: _________________State: _____Zip: __________Phone: __________________Fax: ___________________----------------------Above this Line for Official Use Only--------------------- NOTICE OF COMPLETION—INDIVIDUAL (N.R.S. §108.228) (Assessor's Parcel Numbers: ____________________________________ ) BE IT NOW KNOWN THAT improvements on the property located at ________________________________________________________________________ were completed on the _____ day of _______________, 20______, or work has ceased on said improvements for a period longer than thirty (30) days. If work on improvements has ceased, said improvements ceased on the _____, day of _______________, 20______ and lasted for approximately __________ days. The owner's name is ________________________________. The owner's address is _______________________________________________________________________. The nature of the title of the person signing this notice is _______________________________.A description of the property sufficient for identification is ________________________________________________________________________ ________________________________________________________________________________________________________________________________________________[Description of Property] (If provided in metes and bounds, also include the name and mailing address of the person who prepared the legal description. If a document including the same legal description previously has been recorded, include all information necessary to identify and locate the previous recording, but not the name and mailing address of the person who prepared the legal description).The name of the contractor, if any, is _______________________________.This the _____ day of ______________, 20______ . Notice of Completion Page 2 of 2 ___________________________Signature ___________________________ Type or Print Name State of Nevada ) ) ss.County of _________________)__________________________________ (print name), being first duly sworn on oath according to law, deposes and says:I have read the foregoing Notice of Completion, know the contents thereof and state that the same is true of my own personal knowledge, except those matters stated upon information and belief, and, as to those matters, I believe them to be true. ___________________________________________ (Authorized Signature of Lien Claimant)Subscribed and sworn to before me this _____ day of the month of ____________ of the year _______.______________________________ Notary Public in and for the County and State Certificate of Delivery I, __________________________________, hereby certify that I have delivered this day a true and correct copy of the foregoing to ________________________________, by mailing a true and correct copy of same by certified U.S. mail, postage prepaid, return receipt requested, within ten (10) days of recordation. So certified this the ____ day of _____________, 20______ . ________________________Signature NV § 108.228(2)