HR Release Document

HR RELEASE DOCUMENT

Parties and Identifying Information

Employer Name:

Employer Address:

Employee Name:

Employee Address:

Personal & Position Information

Employment Start Date:

Current / Final Base Salary (if applicable): $

Separation and Consideration

Separation Date:

Consideration to Employee: Employer agrees to provide the following consideration in exchange for the full release of claims described below: Severance Payment $; Accrued PTO Payout $

Payment Schedule:

Release and Waiver of Claims

In consideration of the payments and benefits described above, and other good and valuable consideration, Employee knowingly and voluntarily releases and forever discharges Employer and its affiliates, subsidiaries, officers, directors, employees, agents and assigns from any and all claims, demands, liabilities, actions, causes of action, suits or proceedings, whether known or unknown, arising out of or related to Employee's employment or separation, including but not limited to claims for wages, benefits, wrongful discharge, breach of contract, discrimination, harassment, retaliation, tort, and any federal, state or local statutory claims, up to the date of execution of this Release.

Exceptions: This Release does not waive Employee's rights to vested benefits under an employee benefit plan (unless otherwise specified in a separate written agreement), rights arising after the date of this Release, claims that cannot legally be waived, or rights to file a charge with a government agency although Employee waives the right to recover monetary relief from Employer in any such charge to the extent permitted by law.

Confidentiality; Non-Disparagement; Return of Property

Confidentiality: Employee agrees to keep the terms and existence of this Agreement confidential, except as required by law or as necessary to obtain professional advice. Employee will not disclose the amount or terms of consideration except to a spouse, attorney, or tax advisor who agrees to keep such information confidential.

Non-Disparagement: Employee agrees not to make false or disparaging statements about Employer, its officers, directors, managers or employees. Employer agrees that its executives will not make disparaging statements about Employee.

Return of Property: Employee represents that he/she has returned all Employer property, including but not limited to keys, access cards, electronic devices, documents, and confidential information. If any property remains, Employee authorizes Employer to deduct the fair value from amounts owed, to the extent permitted by law.

Tax Treatment; No Admission of Liability

Tax Withholding: Employer will withhold taxes from payments as required by law. Employee is solely responsible for all federal, state and local taxes applicable to the consideration provided.

No Admission: This Agreement is not an admission of liability by Employer, and both parties expressly deny any wrongdoing.

Cooperation; Further Assurances; Governing Law

Cooperation: Employee agrees to cooperate reasonably with Employer after execution of this Agreement in any legitimate matters related to Employee's duties or matters occurring during Employee's employment, subject to reimbursement of reasonable expenses when appropriate.

Governing Law: This Agreement shall be governed by and construed in accordance with the laws of the state in which Employee performed the majority of his/her work for Employer, without giving effect to choice of law principles that would result in the application of another jurisdiction's law.

Employee Certifications and Acknowledgments

At-Will Employment Statement: Employee acknowledges that, unless otherwise agreed in a written signed contract, employment with Employer was and remains at-will and may be terminated by either party at any time, with or without cause.

Equal Opportunity Statement: Employer 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.

I certify that all information provided in this document and any attachments is true and complete to the best of my knowledge. I acknowledge that I have read this Release and fully understand its terms, including that I am waiving certain legal rights I may have had, and that I have been given a reasonable period to consider this Agreement and to consult with counsel.

I authorize Employer and its agents to contact my previous employers and references and to conduct background checks to verify the information I have provided and to confirm facts relevant to the separation and post-employment obligations.

Employment History

Education

Graduation Date:

References

Representations and Remedies

Employee represents that he/she has not filed or assigned any claim related to employment other than those disclosed to Employer in writing. Employee acknowledges that any breach of the confidentiality or non-disparagement provisions may entitle Employer to injunctive relief and other remedies.

Voluntary Execution and Revocation

Employee acknowledges that he/she has had the opportunity to consult with counsel of his/her choice, has read and understands this Agreement, and signs it voluntarily. If federal law requires a revocation period for certain claims, Employee acknowledges that any such revocation period begins on the date Employee signs this Agreement and any revocation must be made in writing in accordance with the terms set forth here.

Optional Attachments and Notices

Attachments: The following attachments, if completed and attached, are incorporated into this Agreement: Separation Payment Schedule, COBRA/Benefits Election Notice, and any executed Mutual Confidentiality Agreement.

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