Involuntary Separation Agreement

INVOLUNTARY SEPARATION AGREEMENT

Parties and Effective Date

This Involuntary Separation Agreement (the Agreement) is entered into between Employer Name: and Employee Name: . The Separation Effective Date is .

Employee Personal Information

Position and Employment Details

Job Title: Department: Reporting Manager:

Date of Hire: Final Regular Pay Rate (per annum or hourly):

Employee Personnel Summary

The following information is provided to the extent relevant to the separation.

Employment History (Most Recent)

Education

References

Separation Terms and Consideration

Separation Date: Last Day Worked (if different):

Employee will receive final wages for all earned but unpaid salary and accrued paid time off in the amount of $, subject to required payroll deductions.

As consideration for the Release set forth below, Employer agrees to provide Severance Pay in the gross amount of $, to be paid as follows:

Employee may be eligible to continue certain employer-sponsored benefits at Employee's expense where permitted by plan terms. Employer will provide information regarding benefit continuation and conversion options. Any Employer contribution after the Separation Date is expressly stated in this Agreement.

Release of Claims

In exchange for the consideration described above, Employee, on behalf of Employee and Employee's heirs, executors, administrators and assigns, releases and forever discharges Employer and its officers, directors, employees, agents, affiliates and successors from any and all claims, demands, causes of action, liabilities or damages, whether known or unknown, suspected or unsuspected, arising out of or relating to Employee's employment with Employer or separation from employment through the Separation Date, including but not limited to claims for wrongful termination, breach of contract, discrimination, harassment, retaliation, tort, and statutes of any sort to the full extent permitted by law.

Exceptions: The Release does not preclude Employee from (a) claims that may arise after the Separation Date, (b) vested retirement benefits under plan terms, (c) rights to unemployment insurance benefits to the extent allowed by law, or (d) rights to challenge the validity of the Release under applicable statutory revocation periods where such periods apply.

Employee represents that Employee has read and understands the terms of this Release, that Employee has had the opportunity to consult with independent legal counsel, and that Employee voluntarily executes this Agreement. Employee acknowledges receipt of sufficient consideration to support this Release.

Confidentiality; Non-Disparagement

Employee agrees to keep the terms of this Agreement confidential, except as required by law or as necessary to obtain professional or financial advice. Employee agrees not to make false or disparaging statements about Employer, its employees or representatives. Employer agrees to instruct managers and human resources personnel not to disparage Employee in written or oral statements.

Return of Property; Cooperation

Employee shall return all Employer property, including but not limited to keys, records, electronic devices, access cards, documents and proprietary information, by the Separation Date. Employee agrees to cooperate with Employer in the orderly transition of duties and to execute documents reasonably necessary to give effect to this Agreement.

Tax Withholding; No Admission

All payments made under this Agreement shall be subject to applicable tax withholdings and payroll deductions. This Agreement does not constitute an admission of liability or wrongdoing by Employer.

At-Will Employment; Equal Opportunity

Nothing in this Agreement alters the at-will nature of Employee's employment (if applicable), nor does this Agreement create a promise of continued employment. Employer maintains an equal employment opportunity policy and does not discriminate on protected bases.

Authorization to Verify and Release Information

Employee authorizes Employer and its representatives to verify Employee's employment history, references and other information provided by Employee. Employee hereby releases any prior employers and references from liability for providing such information to Employer.

Consent to Background Check: I hereby authorize verification of my background, employment history and references.

Acknowledgment and Certification

I certify that the information provided in this document is true and complete to the best of my knowledge and that I have read and understand the terms of this Agreement. I acknowledge that I have been advised to consult with an attorney before signing and that I have been given a reasonable period to consider this Agreement.

Employee Initials:

Governing Law; Miscellaneous

This Agreement shall be governed by and construed in accordance with the laws of the state specified below without regard to conflict of laws principles. Governing Law State:

If any provision of this Agreement is found to be invalid or unenforceable, the remaining provisions shall remain in full force and effect. This Agreement constitutes the entire understanding between the parties with respect to the subject matter herein and supersedes any prior agreements or understandings, whether written or oral.

Employee Consideration Period

Employee acknowledges receipt of the Agreement on and understands that Employee has a reasonable period to consider this Agreement and may revoke acceptance within the company-stated revocation period where applicable.

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