Employee Release from Liability

EMPLOYEE RELEASE FROM LIABILITY

Parties and Effective Date

This Employee Release from Liability (the Agreement) is entered into by and between Employee Name: and Employer Name: . The effective date of this Agreement is (Effective Date).

Employee Information

Position and Separation Details

Reporting Manager: | Start Date: | Separation Date:

Consideration

In exchange for the promises and releases contained in this Agreement, Employer agrees to provide Employee the following consideration which Employee acknowledges as fair and adequate:

Release of Claims by Employee

For and in consideration of the consideration described above, Employee, on behalf of Employee, Employee's heirs, executors, administrators, successors and assigns, hereby fully and forever releases, waives and discharges Employer and its parent, subsidiaries, affiliates, predecessors, successors, officers, directors, employees, agents and insurers (Released Parties) from any and all claims, demands, causes of action, liabilities or remedies of any nature, whether known or unknown, asserted or unasserted, arising out of or relating to Employee's employment, the termination of employment, or any acts, omissions or events occurring prior to the Effective Date, including but not limited to claims for wages, benefits, tort, contract, discrimination, harassment, retaliation, wrongful termination, and any statutory or common law claims.

Employee acknowledges that this release does not cover claims that cannot be waived as a matter of law and does not preclude Employee from filing a charge with an administrative agency where applicable, although Employee expressly waives the right to recover monetary or other individual relief through such proceedings to the fullest extent permitted by law.

Confidentiality and Non-Disparagement

Employee agrees to keep the terms, amounts and existence of this Agreement strictly confidential and will not disclose such information to third parties other than Employee's spouse, attorney or tax advisor, except as required by law. Employee further agrees not to make any false or disparaging statements concerning the Released Parties. This confidentiality obligation shall continue for following the Effective Date.

Return of Company Property and Cooperation

Tax and Withholding Acknowledgement

Employee acknowledges that any monetary consideration paid pursuant to this Agreement may be subject to applicable tax withholding and that Employer will report payments as required by law. Employee is responsible for any personal tax obligations arising from payments under this Agreement.

Representations and Acknowledgements

Employee represents and warrants that Employee has read and fully understands the terms of this Agreement, has been given the opportunity to consult with counsel of Employee's choice, and has signed this Agreement voluntarily and without duress. Employee further represents that Employee has not assigned or transferred any claim released herein to any other person or entity.

Dispute Resolution and Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the State of . Any disputes arising under this Agreement shall be resolved in the courts located in , unless otherwise agreed in writing.

General Provisions

Severability: If any provision of this Agreement is held to be invalid or unenforceable, the remaining provisions shall continue in full force and effect. Entire Agreement: This Agreement constitutes the entire agreement between the parties concerning the subject matter herein and supersedes all prior agreements and understandings, both written and oral.

Employment History (for employer records)

Education

References

Legal Notices and Disclosures

At-Will Employment: Nothing in this Agreement alters the at-will nature of employment, if applicable, unless otherwise expressly set forth in a separate written agreement executed by both parties.

Equal Opportunity: Employer does not discriminate on the basis of race, color, religion, sex, national origin, age, disability or any other characteristic protected by applicable law.

Applicant Certification and Authorizations

I certify that all information provided in connection with this Agreement and in the Employment History, Education and References sections is true and complete to the best of my knowledge. I understand that any material misrepresentation or omission may constitute grounds for rescission of this Agreement and other remedies available to Employer.

Authorization to Contact References and Prior Employers: I authorize Employer to contact the references and prior employers listed above for the purpose of verifying information.

Authorization for Background Checks: I authorize Employer to obtain background information as necessary to verify facts relevant to employment and separation matters, subject to applicable law.

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