Dram Shop Liability Complaint - Nebraska

Nebraska Personal Injury Updated October 8, 2026 Free Word and PDF

COMPLAINT — MINOR ALCOHOLIC LIQUOR LIABILITY ACT

IN THE DISTRICT COURT OF [________________________________] COUNTY, NEBRASKA

Party Role
[PLAINTIFF NAME] Plaintiff
v.
[FURNISHING DEFENDANT NAME] Defendant

Case No.: [________________________________]

Plaintiff, by counsel, alleges as follows:

Parties, jurisdiction, and venue

  1. Plaintiff [NAME] is [an injured person / the duly appointed personal representative of the estate of DECEDENT NAME]. If proceeding for a death, Plaintiff brings the claim in that representative capacity for the persons identified under Neb. Rev. Stat. § 30-810.

  2. Defendant [NAME] is a [Nebraska retailer / social host / person who procured alcoholic liquor] with an address at [________________________________].

  3. This Court has subject-matter jurisdiction under Neb. Rev. Stat. § 24-302. Venue is proper in this county under Neb. Rev. Stat. § 25-403.01 because [DEFENDANT RESIDES HERE / THE CAUSE OF ACTION AROSE HERE / RELEVANT TRANSACTION OCCURRED HERE].

Facts

  1. On [__/__/____], [MINOR NAME] was [____] years old, under the age of twenty-one, and consumed alcoholic liquor at [PLACE] in [COUNTY], Nebraska.

  2. Defendant's role was [SELECT AND COMPLETE ONE OR MORE APPLICABLE ALLEGATIONS]:

☐ Social host: Defendant knowingly allowed the minor to consume alcoholic liquor in Defendant's home or on property under Defendant's control at [PLACE]. Defendant was not a parent providing alcoholic liquor only to that parent's minor child, or a religious entity or authorized representative dispensing it as part of a bona fide religious rite, ritual, or ceremony. Neb. Rev. Stat. § 53-403(7).

☐ Procurer: Defendant procured [TYPE AND AMOUNT OF ALCOHOLIC LIQUOR] for the minor, knew or should have known the recipient was under twenty-one, and did not act with the permission and in the company of the minor's parent or guardian. Neb. Rev. Stat. § 53-404(2).

☐ Retailer: Defendant, a retailer under the Act, sold [TYPE AND AMOUNT OF ALCOHOLIC LIQUOR] to the minor at [PLACE]. Neb. Rev. Stat. § 53-404(3).

  1. After consuming the alcoholic liquor, the minor became intoxicated. The minor's faculties were impaired as follows: [SPECIFIC OBSERVATIONS].

  2. While intoxicated, the minor negligently [SPECIFIC CONDUCT] at [PLACE] on [__/__/____]. The intoxication contributed to that negligent conduct because [FACTS LINKING IMPAIRMENT TO CONDUCT].

  3. The minor's negligent conduct proximately caused [PLAINTIFF'S INJURY / PROPERTY DAMAGE / DECEDENT'S DEATH] as follows: [FACTS AND CAUSATION].

Count I — Statutory liability under Neb. Rev. Stat. § 53-404

  1. Plaintiff incorporates paragraphs 1 through 8.

  2. Defendant is a qualifying [social host / procurer / retailer] under the Minor Alcoholic Liquor Liability Act because [FACTS MATCHING THE SELECTED ROLE].

  3. Plaintiff [sustained injury or property damage / brings this claim on behalf of the estate of a person killed] as a proximate result of the negligence of an intoxicated minor, and the intoxication contributed to that conduct.

  4. Plaintiff seeks actual damages caused by that conduct under the Act, including the following supported items: [MEDICAL EXPENSES, LOST EARNINGS, PROPERTY LOSS, OR OTHER APPLICABLE ACTUAL DAMAGES AND AMOUNTS]. For a death claim, specify the beneficiaries and the losses claimed for them: [________________________________].

Request for relief

Plaintiff requests judgment against Defendant for:

  1. Actual damages in an amount proved at trial;
  2. Recoverable costs and interest, if authorized by applicable law; and
  3. Other relief the Court finds lawful and proper.

Plaintiff requests trial by jury on issues triable by jury.

Dated: [__/__/____]

Attorney signature: __________________________________

Printed name and Nebraska bar number: [________________________________]

Firm and address: [________________________________]

Phone and email: [________________________________]

Counsel for Plaintiff

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About this template

Last updated
October 8, 2026
Citations checked
October 8, 2026
Jurisdiction
Nebraska
Category
Personal Injury

Legal authority

  • Neb. Rev. Stat. §§ 53-401 to 53-409 (Minor Alcoholic Liquor Liability Act)
  • Neb. Rev. Stat. § 53-403 (Definitions)
  • Neb. Rev. Stat. § 53-404 (Cause of action)
  • Neb. Rev. Stat. § 53-408 (Limitations)
  • Neb. Rev. Stat. § 53-180.07 (Retailer defenses)
  • Neb. Rev. Stat. § 53-103.23 (Minor defined)
  • Neb. Rev. Stat. § 30-810 (Wrongful-death representative, if applicable)
  • Neb. Rev. Stat. § 24-302 (District court jurisdiction)
  • Neb. Rev. Stat. § 25-403.01 (Venue)

Personal injury cases are brought by people who were hurt because of someone else's carelessness: car crashes, slip and falls, defective products, and more. Demand letters, settlement agreements, and court filings in these cases have to document the injuries, the medical treatment, the lost income, and the exact legal basis for holding the other side responsible. Well-prepared paperwork is what drives higher settlements and forces insurers to take the claim seriously.

Not legal advice

This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.

Checked against the law it cites

A reviewer verified this template's legal citations against the official source on October 8, 2026.

Neb. Rev. Stat. § 24-302 (checked October 8, 2026): "The district courts shall have and exercise general, original and appellate jurisdiction in all matters, both civil and criminal, except where otherwise provided."

Neb. Rev. Stat. § 25-403.01 (checked October 8, 2026): "Any action, other than the actions mentioned in sections 25-401 to 25-403, may be brought (1) in the county where any defendant resides, (2) in the county where the cause of action arose, (3) in the county where the transaction or some part of the transaction occurred out of which the cause of action arose, or (4) if all defendants are nonresidents of this state, in any county."

Neb. Rev. Stat. §§ 53-401 to 53-409 (checked October 8, 2026): "Sections 53-401 to 53-409 shall be known and may be cited as the Minor Alcoholic Liquor Liability Act."

Neb. Rev. Stat. § 53-403(7) (checked October 8, 2026): "Social host means a person who knowingly allows consumption of alcoholic liquor in his or her home or on property under his or her control by one or more minors."

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