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IN VALUABLE CONSIDERATION of payment of the amount of ________ [$-----] and other valuable consideration received, I, ________ [Name] of ________ [Address], hereinafter referred to as "Undersigned", his or her heirs, executors, successors, and assigns release from all claims, debts and liabilities owed to me by ________ [Name] of _______ [Address] as of the date and execution of this release.
[state the nature of cause of release]
It further releases ________ [Name] from all actions, accounts, suits, debts, judgments, financial dues, bonds, bills, sums of money, covenants, contracts, promises, variances, damages, liens, executions and demands in law relating to any and all legal proceedings presently undertaken and commenced by Undersigned.
Neither party has made any representations nor promises, other than those contained in this Release or in some further writing signed by the party making the representation or promise.
Each party, at the request of the other, will execute and deliver all documents which may be reasonably necessary to give full effect to this Release.
This Release may be modified or amended, if the amendment is made in writing and is signed by both parties.
Time of the Essence. Time is of the essence of this Release.
This release may not be changed orally.
IN WITNESS WHEREOF, I have hereunto set my hand and seal the [date].
ACKNOWLEDGEMENT BY NOTARY PUBLIC
State of ________)
On ________, before me, ________, [NAME OF NOTARY], personally appeared ________, [NAME OF PERSON(S) INVOLVED], who proved to me on the basis of satisfactory evidence to be the person(s) whose names(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies) and that by his/her/their signatures on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under the PENALTY OF PERJURY under the laws of the State of _________ that the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Name of Notary
My Commission Expires