Employee Severance and Release

EMPLOYEE SEVERANCE AND RELEASE

Parties and Effective Date

This Employee Severance and Release Agreement (the Agreement) is entered into between:

Employer Name:

Employee Name:

Effective Date of Separation:

Personal Information

Position Information

Date of Hire:     Current Annual Salary (or last rate):

Severance Consideration and Benefits

In exchange for the releases and covenants set forth in this Agreement, Employer agrees to provide the following consideration to Employee (the Severance Benefits):

All payments are subject to applicable tax withholdings and deductions. Employee acknowledges that the Severance Benefits do not constitute wages for purposes of any bonus or commission plan unless expressly stated above.

Release of Claims

In consideration of the Severance Benefits, Employee, on behalf of Employee and Employee's heirs, assigns, agents and representatives, hereby fully and forever releases and discharges Employer and its past and present parents, subsidiaries, affiliates, officers, directors, employees, agents and insurers from any and all claims, demands, causes of action, liabilities, obligations, costs, expenses and damages of every kind, whether known or unknown, arising out of or relating to Employee's employment with Employer or the termination of that employment through the Effective Date, including but not limited to claims under federal, state or local statutes for discrimination, retaliation, wrongful termination, breach of contract, tort, and any other statutory or common law claims.

Employee expressly waives any rights under any statutes or laws that permit a release of unknown claims to the extent permitted by law. This release does not cover (a) rights that cannot be waived by law, (b) rights to indemnification or insurance coverage to the extent required by law, or (c) claims that arise after the Effective Date.

Confidentiality and Non-Disparagement

Employee agrees to keep the terms and amount of this Agreement confidential except as required by law or as necessary to obtain legal or tax advice. Employee agrees not to make any statements, written or oral, that defame, disparage or injure the reputation of Employer or its officers, directors or employees. Employer agrees that it will not make disparaging statements about Employee in response to neutral or fact-based employment verification inquiries.

Return of Property and Cooperation

Employee represents that, except as disclosed in writing to Employer, Employee has returned all Employer property, records, documents, keys, access cards, and electronic devices. Employee agrees to cooperate, at Employer's request and expense, in any reasonable transition matters for a limited period after the Effective Date.

Acknowledgments; Right to Consider and Revoke

Employee acknowledges that Employee has been advised to consult with an attorney prior to signing this Agreement and that Employee has been given adequate time to consider the terms. If Employee is age 40 or older, Employee acknowledges that the Age Discrimination in Employment Act imposes additional requirements on waivers of age claims, including a 21-day consideration period and a seven-day revocation period; where required, these periods shall be observed as applicable.

Tax Withholding and Legal Effect

Employer will withhold applicable federal, state and local payroll taxes from payments required by law. This Agreement does not constitute an admission of liability or wrongdoing by either party. The remedies provided in this Agreement are exclusive and cumulative.

Governing Law and Severability

This Agreement shall be governed by and construed in accordance with the laws of the state specified by Employer without regard to conflict-of-law principles, except where federal law controls. If any provision of this Agreement is found to be unenforceable, the remaining provisions shall continue in full force and effect.

Employee Certifications and Authorizations

By signing below, Employee certifies that all information provided in this Agreement and accompanying attachments is true and complete to the best of Employee's knowledge. Employee authorizes Employer to contact any former employers, references, or other entities identified in Employee's personnel records for purposes related to this Agreement and to confirm employment history.

Employee authorizes Employer to contact prior employers and references as necessary for verification and background checks.

Employment History (Most Recent Employers)

Education

References

At-Will Employment; Equal Opportunity

Nothing in this Agreement alters the at-will nature of employment except as expressly set forth herein. Employer remains an equal opportunity employer and does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, genetic information, or any other protected characteristic under applicable law.

Applicant / Employee Certification

I certify that all information provided in this document is true and complete. I understand that falsification, omission, or misrepresentation of information may result in forfeiture of Severance Benefits and may be grounds for legal action.

I certify the above statement.

Optional Employee Statement (optional)

Miscellaneous Provisions

This Agreement constitutes the entire agreement between the parties relating to the subject matter hereof and supersedes all prior agreements, representations and understandings, whether written or oral. Any modification must be in writing and signed by both parties. If any provision is held invalid, the remainder shall remain enforceable.

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