HR Quitclaim Release Form

HR Quitclaim Release Form

Recitals

Employer Name:

Employee Name:

Date of Separation:

Personal Information

Position Information

Employment History (Most Recent Two Employers)

Education

References

Legal Disclosures

At-Will Employment: Employee acknowledges and agrees that employment with Employer was, and remains if applicable, at-will and may be terminated by either party at any time, with or without cause, except as modified by a written agreement signed by an authorized representative of Employer.

Equal Employment Opportunity: Employer affirms its commitment to equal employment opportunity. No term of this Release shall be construed to diminish any right of Employee to be free from discrimination under applicable law, except as explicitly waived herein.

Quitclaim and Consideration

In exchange for the consideration described below, Employee knowingly and voluntarily releases and forever discharges Employer, its past and present affiliates, parent companies, subsidiaries, officers, directors, employees, agents and insurers from any and all claims, demands, causes of action, liabilities and damages of any nature, whether known or unknown, which Employee ever had or may have against Employer up to the Effective Date of this Release.

Payment Terms: Payment is subject to standard payroll deductions and withholdings, if applicable, and will be paid in accordance with Employer's normal payroll practices unless otherwise stated above.

Scope of Release and Exceptions

This Release covers all claims of any nature arising prior to the Effective Date, including but not limited to claims for wages, bonuses, overtime, breach of contract, tort, discrimination, harassment, wrongful termination, and any statutory or common law claims, except claims that cannot be waived as a matter of law. This Release does not apply to: (a) any rights to vested benefits under a qualified retirement plan; (b) rights to unemployment insurance; (c) claims arising after the Effective Date; (d) criminal claims; or (e) claims that, under controlling law, cannot be released by private agreement.

Confidentiality and Non-Disparagement

Confidentiality: Employee agrees to keep the terms, amount and existence of this Release confidential, except as required by law, compelled by legal process, or to obtain legal or tax advice. Non-Disparagement: Employee agrees not to make any false or disparaging statements about Employer, its officers, directors or employees.

Employee acknowledges that a breach of confidentiality or non-disparagement may constitute a material breach of this Release and may subject Employee to remedies including injunctive relief and damages.

Acknowledgements, Certifications and Waiver

Employee acknowledges and represents that Employee has read this Release in its entirety, understands its terms, and has had the opportunity to consult with an attorney of Employee's choice prior to signing. Employee certifies that all information provided herein is true and complete to the best of Employee's knowledge.

Employee expressly acknowledges that this Release is intended to be a full and final settlement and releasement of claims described herein and that Employee is entering into this Release voluntarily and not in reliance on any statement or representation not contained herein.

Authorization to Verify and Background Checks

Employee hereby authorizes Employer and its agents to verify information contained in this form and to contact prior employers and references for the purpose of verifying employment history and background. Employee further authorizes the release of employment records and other information to Employer and acknowledges that Employer may rely on such information in connection with administering the Release.

I authorize contact with prior employers and references: Yes

Tax Treatment

Employee understands and agrees that Employee is solely responsible for the reporting and payment of any taxes on the consideration paid pursuant to this Release, and Employer makes no representation regarding tax consequences. Employee should consult a tax advisor regarding the tax treatment of any payments.

Voluntary Execution

By signing below, Employee acknowledges that Employee has read and understands this Quitclaim Release Form, that Employee is aware of the rights being waived and released, and that Employee signs this Release voluntarily and without coercion. Employee further acknowledges receipt of the consideration described above.

Applicant Certification

I certify that all information provided on this form is true and complete to the best of my knowledge. I understand that any false statements may be grounds for rescission of this agreement or other remedies available to Employer.

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