Release of Claim
RELEASE FOR THE SOLE CONSIDERATION OF __________________ Dollars, and other consideration, the receipt and sufficiency whereof is hereby acknowledged, the undersigned hereby releases and forever discharges ___________________________, their heirs, executors, administrators, agents and assigns, and all other persons, firms or corporations liable or who might be claimed to be liable, none of whom admit any liability to the undersigned but all expressly deny any liability, from any and all claims, demands, damages, actions, causes of action or suits of any kind or nature whatsoever, and particularly on account of all injuries, known and unknown, both to person and property, which have resulted or may in the future develop from an accident which occurred on or about the day of ,19 , at or near ______________ __________________________________________________________. The undersigned hereby declares that the terms of this settlement have been completely read and are fully understood and voluntarily accepted for the purpose of making a full and final compromise adjustment and settlement of any and all claims, disputed or otherwise, on account of the injuries and damages above mentioned, and for the express purpose of precluding forever and further additional claims arising out of the aforesaid accident. The undersigned hereby accepts draft or drafts as final payment of the consideration set forth above. IN WITNESS WHEREOF, we have hereunto set our hands and seals this ___ day of __________, 19__. Signed, sealed and delivered in the presence of: ___________________________ _______________________(SEAL) ___________________________ _______________________(SEAL)
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