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Release Agreement in Letter Form of Employer By Employee for Alleged Violations of Fair Employment Practices Statutes with Form for Employee’s Acceptance (upon Termination of Employment) _______________________________________________ (Date) ____________________________________________________________ (Name of Employee) _____________________________________________________________________________ ___________________________________________________________ (Address of Employee) Dear ________________________________________________________ (Name of Employee) The purpose of this letter is the serve as the formal notice of your lay-off effective _____________________________________________________ (date) , and to state that in appreciation of your loyal service to ________________________________________________ ___________________________ (Name of Employer), and in consideration of your agreement to the terms and conditions of this letter , _____________________________________________ (Name of Officer) , the President and CEO of _________________________________________ (Name of Employer), has authorized a severance package that exceeds the severance payments to which you would otherwise be entitled under the termination policy of ___________________ _________________________________ (Name of Employer). To be eligible for this additional consideration you must return to the undersigned a signed copy of this letter . Should you choose not to sign this letter , you will receive the normal severance of (e.g., one week's pay for each full six months of service and medical coverage for ____days after your date of termination) ________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________ . Instead of the above normal severance, ________________________________________ ________________________________ (Name of Employer), offers you the following: (the following paragraphs 1 – 4 are sample inducements, terms and conditions :) 1. A lump-sum payment equivalent to one week's pay at your current salary for each full six months of service calculated to ______________________________________________ (date) . Additionally, you will be given four more weeks' pay at your current salary. The gross amount of such payment is $________________. 2. As an alternative to the lump-sum payment under Paragraph 1, you may elect to be paid (e.g., 48) ____________ weeks' salary, less applicable withholdings, from the date of your termination. The timing of the salary payments will be in accordance with the payroll practices of ___________________________________________________________________ (Name of Employer). The period you are paid under Paragraphs 1 or 2 shall be referred to in this letter as the payment period. 3. Under the earlier of such time as you commence employment with another employer or become eligible for other health (medical and dental) coverage, or the expiration of the payment period, and so long as you continue to make employee contributions, you will continue to receive medical and dental insurance benefits which are offered to employees of _____________________________________________________________________ (Name of Employer), under the company's then existing plans. __________________________________ _______________________________________ (Name of Employer) ’s short and long-term disability plans, 401(k) and retirement plans (except for amounts, if any, vested under _____________________________________________________________________ (Name of Employer) ’s 401(k) and retirement plans), life insurance plan and vacation shall terminate as of your termination date. 3. _________________________________________________________________ (Name of Employer) will pay for outplacement services to be provided by ________________________ ________________________________ (Name of Provider) . 4. A letter of recommendation will be given if you so desire. The wording of the letter will be at the sole discretion of ________________________________________________________ ___________________________ (Name of Employer) . 5. You agree to treat as confidential and not to disclose any confidential materials or information that you have learned or discovered during your employment by _____________________________________________________________________ (Name of Employer) and its affiliates, and what you may learn or discover through your separation, including the terms of this letter . You also agree to refrain from disparaging or holding up to ridicule the name of _____________________________________________________________ (Name of Employer) and its affiliates, directors, officers and employees. You represent that you will return all materials and property of _____________________________________________ _______________________________ (Name of Employer ) . 6. In consideration of the payments to you as described above, and the receipt by you of the other benefits under this agreement, you irrevocably and unconditionally release and discharge ____________________________________________________________________ (Name of Employer) and its affiliates, officers, directors, employees and agents from liability for any claims that you may have against it and them as of the date of your signing this letter agreement, whether known or unknown to you, including, but not limited to, any claims arising under or violations of federal, state or local fair employment practices [such as Title VII of the Civil Rights Act of 1964, the Age Discrimination in Employment Act of 1967 , the Federal Family and Medical Leave Act, the Pregnancy Discrimination Act, the Fair Labor Standards Act, and the _______________________________________________ (cite any state fair employment act)] , or other employee relations statutes and laws, including any rules, executive orders, laws or ordinances, torts, express or implied contracts, public policy, or other obligations related to your employment with _______________________________________________________________ (Name of Employer). 7. You agree and acknowledge that this letter agreement constitutes a full and final release not only of any and all claims at the present time known or anticipated by you, but also any and all claims by you that do exist, may exist or previously have existed against _____________________________________________________________________ (Name of Employer), regardless of whether such claims, or the facts underlying such claims, were known or unknown, anticipated or unanticipated, by you. It is your intention to fully, finally and forever settle and release all claims that do exist, may exist or previously have existed by you against _____________________________________________________________________ (Name of Employer), its affiliated companies and their respective officers, directors and employees. In furtherance of such intention, the release given in Paragraph 6, above, shall be and remain in effect as a full and complete release of such matters notwithstanding the discovery by you of the existence of any additional or different claims or of the facts relative to the same. Please advise the undersigned within ____________ (number) days from the date of your receipt of this letter whether or not you accept the terms of this offer . The acceptance must be evidenced in the manner set forth below. If you choose not to accept the offer within such period, it will be considered withdrawn. Please take your time in considering this offer and consult with any attorney you choose. Please indicate your understanding, acceptance and approval of this letter agreement by signing your name, dating your signature in the space provided below, and returning the enclosed signed copy of the letter agreement to the undersigned within ___________ (number) days of your receipt of this letter agreement. The extra enclosed original is for your records. If you have any questions about the content of this letter agreement, please contact the undersigned. Sincerely yours, __________________________________________ (Name of Employer) By: ______________________________________ __________________________________________ (Name and Office in Corporation) Acceptance by Employee I hereby accept the terms and conditions set forth in the above letter and agree to be legally bound by the same. Witness my signature this __________________________________________________ (date). ______ ___________________________________ _________________________________________ (Printed Name & Signature of Beneficiary