Claim of Lien - Individual (Nebraska)

This Claim of Lien form is for use by an individual to swear on oath that he or she is the lienor or an agent of the lienor and to provide his or her address, the name and person with whom he or she contracted with to furnish labor, services, or materials on certain real property, and includes the type of labor, services, or materials furnished, a legal description of the property, the amount unpaid, the dates the labor, services, or materials were furnished, the date and method of service of the notice upon the owner if the lien is claimed by one not in privity with the owner), and the date and method of service upon the contractor and subcontractor, if required.