Legal Assault Form

LEGAL ASSAULT FORM

This Assault Settlement and Release Agreement (the "Agreement") is entered into as of Effective Date: by and between Complainant Name: ("Complainant") and Respondent Name: ("Respondent").

RECITALS

WHEREAS, Complainant alleges that Respondent engaged in certain conduct on Date of Incident: resulting in physical and/or emotional injury to Complainant at Location: ; and

WHEREAS, the parties desire to resolve fully and finally all disputes, claims, demands, and causes of action that Complainant may have against Respondent arising out of or relating to the incident described herein, without admission of liability by Respondent; and

WHEREAS, the parties acknowledge that settlement of disputed claims is in their mutual interest and that this Agreement memorializes the complete terms of the settlement and release.

NOW, THEREFORE

In consideration of the mutual covenants contained herein and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows:

1. INCIDENT DESCRIPTION

Complainant provides the following factual description of the alleged assault. This statement will be relied upon by the parties for purposes of settlement and may be used to identify the scope of released claims.

2. SETTLEMENT CONSIDERATION

In full and final settlement of all claims that Complainant may have against Respondent arising out of or related to the Incident, Respondent agrees to pay Complainant the Settlement Amount: $ subject to the following payment terms.

3. RELEASE AND COVENANT NOT TO SUE

Upon receipt of the Settlement Amount in accordance with Section 2, Complainant fully releases and forever discharges Respondent and its past, present and future agents, insurers, attorneys, employees, predecessors, successors and assigns (collectively, the "Released Parties") from any and all claims, demands, actions, causes of action, suits, debts, liabilities, obligations, losses and damages of every kind and nature, whether known or unknown, suspected or unsuspected, fixed or contingent, which Complainant ever had, now has, or hereafter can, shall or may have against the Released Parties arising out of or related to the Incident, through the Effective Date of this Agreement.

Complainant covenants and agrees not to institute or assist in any lawsuit, arbitration or administrative proceeding against any Released Party with respect to any matter released herein.

4. NON-ADMISSION

The parties expressly agree that this Agreement and the payment and acts performed herein shall not be construed as an admission of liability, wrongdoing, or unlawful conduct by Respondent, who expressly denies liability.

5. CONFIDENTIALITY AND NON-DISPARAGEMENT

Except as required by law or as necessary to effectuate the settlement terms of this Agreement, the parties shall keep the terms, amount and existence of this Agreement confidential. Neither party shall make any public statement or take any action intended to disparage the other party. This confidentiality obligation does not prohibit truthful statements to law enforcement, courts, or counsel representing a party in a legal proceeding.

6. COOPERATION WITH AUTHORITIES

Nothing in this Agreement shall prevent either party from making truthful reports to law enforcement or cooperating with governmental authorities. However, a party who provides information to authorities shall not disclose settlement terms except as required by law.

7. REPRESENTATIONS AND WARRANTIES

Each party represents and warrants that it has full power and authority to enter into this Agreement, that the person signing on its behalf is duly authorized, and that the execution and performance of this Agreement will not violate any other agreement or legal obligation.

8. INDEMNIFICATION

Each party agrees to indemnify, defend and hold harmless the other party from and against any and all claims, liabilities, losses, costs and expenses, including reasonable attorneys' fees, resulting from any breach of the indemnifying party's representations, warranties or obligations under this Agreement.

9. NOTICES

All notices, requests, demands and other communications required or permitted under this Agreement shall be in writing and shall be deemed given when personally delivered, sent by certified mail, return receipt requested, or delivered by nationally recognized overnight courier to the addresses provided below or to such other address as a party may specify by notice in accordance with this Section.

10. AMENDMENT, WAIVER, COUNTERPARTS

This Agreement may not be amended or modified except by a written instrument signed by both parties. No waiver of any breach or default shall be deemed a waiver of any subsequent breach. This Agreement may be executed in counterparts, each of which shall be deemed an original, and signatures transmitted by electronic means shall be valid and binding.

11. GOVERNING LAW; SEVERABILITY; ENTIRE AGREEMENT

This Agreement shall be governed by and construed in accordance with the substantive laws of the state specified below without regard to choice-of-law principles. If any provision of this Agreement is held invalid or unenforceable, such provision shall be modified to the minimum extent necessary to make it valid and enforceable, and the remaining provisions shall remain in full force and effect. This Agreement constitutes the entire understanding and agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, representations and understandings of the parties, whether written or oral.

12. ADDITIONAL ACKNOWLEDGMENTS

Complainant acknowledges that Complainant has been advised of the right to consult with independent legal counsel prior to executing this Agreement and that Complainant executes this Agreement voluntarily, knowingly and without duress.

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