Nebraska Revised Statutes Chapter 57. Minerals, Oil, and Gas § 57-202. Forfeited lease; failure to surrender; notice by landowner; form

If the lessee, his or her successors or assigns, shall fail or neglect to execute and record such surrender within the time provided for, then the owner of the land may serve upon the lessee, his or her successors or assigns, in person or by either registered or certified letter, at his or her last-known address, or by publication for one week in a newspaper of general circulation in the county where the land is situated, a notice in writing in substantially the following form:

To ________________: I, the undersigned, owner of the following described land situated in ____________ County, Nebraska, to wit: (description of land), upon which a lease, dated ________ day of ____________ 20 ____, was given to ____________ do hereby notify you that the terms of the lease have been broken by the owner thereof; that I hereby elect to declare and do declare the lease forfeited and void and that, unless you do, within ten days from this date, notify the register of deeds of such county as provided by law that the lease has not been forfeited, I will file with the register of deeds an affidavit of forfeiture as provided by law; and I hereby demand that you execute or have executed a proper surrender of the lease and that you cause the same to be recorded in the office of the register of deeds of such county, within ten days from this date. Dated this ________ day of ____________ 20 ____.