Legal Settlement Permission

LEGAL SETTLEMENT PERMISSION

This Legal Settlement Permission Agreement (the Agreement) is entered into as of by and between Claimant Name: (hereinafter "Claimant") and Respondent Name: (hereinafter "Respondent"). Collectively, Claimant and Respondent are referred to as the Parties.

RECITALS

WHEREAS, Claimant asserts certain claims, demands or causes of action arising out of or related to (the Claim);

WHEREAS, the Parties desire to resolve the Claim without further litigation and to allocate authority to finalize settlement terms and execute releases consistent with the limitations set forth herein;

WHEREAS, Claimant is willing to grant Respondent limited authority to negotiate, accept and execute settlement documentation and related releases on behalf of Claimant under the terms set forth in this Agreement.

NOW, THEREFORE, in consideration of the mutual covenants contained herein and other good and valuable consideration, the receipt and sufficiency of which are acknowledged, the Parties agree as follows:

1. DEFINITIONS

For purposes of this Agreement: "Settlement" means any agreement, compromise, release or stipulation resolving the Claim; "Released Parties" means Respondent and any persons or entities identified in the Settlement as released; "Authority" means the power granted by Claimant to Respondent under Section 2.

2. GRANT OF AUTHORITY

Claimant hereby grants Respondent the Authority to negotiate and enter into a Settlement on Claimant's behalf, to execute any and all releases, dismissals, settlement agreements, receipts and related instruments necessary to effectuate such Settlement, and to accept payment on Claimant's behalf, provided that any Settlement shall be consistent with the scope and monetary limits set forth in Section 3.

3. SCOPE AND LIMITATIONS

Authority is granted as follows (select one):

General authority to settle any and all claims related to the Claim within the monetary limit specified below.

Limited authority (describe limitations below):

Monetary limit for Authority (if any): $ . Any Settlement exceeding this amount shall require Claimant's prior written approval.

4. CONSIDERATION

In consideration for the Authority granted herein, Claimant acknowledges receipt of consideration consisting of the mutual covenants contained in this Agreement and any Settlement amounts actually paid pursuant to a Settlement. The principal settlement amount agreed or received shall be: $.

5. RELEASE AND COVENANT NOT TO SUE

Upon Claimant's receipt of the consideration specified in a Settlement, Claimant shall execute and deliver releases in favor of the Released Parties releasing and forever discharging them from all claims, demands, causes of action, liabilities and damages of every kind relating to the Claim. Claimant covenants not to institute or pursue any further action against the Released Parties with respect to matters covered by the executed release.

6. PAYMENT AND DELIVERY

Payment shall be made in the form and to the payee specified below. Claimant hereby authorizes Respondent to accept and endorse settlement checks or other consideration and to deliver or direct payment in accordance with the payment instructions set forth by Claimant.

7. REPRESENTATIONS AND WARRANTIES

Claimant represents and warrants that: (a) Claimant is the sole owner of the claims being settled or has full authority to grant this Permission; (b) the execution and performance of this Agreement do not violate any other agreement to which Claimant is bound; and (c) Claimant has not assigned the Claim to any third party. Each Party represents that it has full power and authority to enter into this Agreement.

8. CONFIDENTIALITY

The Parties agree that Settlement terms shall be treated as confidential and shall not be disclosed to any non-party except as required by law or to obtain legal, tax or accounting advice. If the Parties agree that the Settlement is confidential, check below:

Confidential settlement required

9. INDEMNIFICATION

Each Party agrees to indemnify and hold harmless the other Party from and against any losses, liabilities, claims, costs and expenses (including reasonable attorneys' fees) arising out of a breach of such Party's representations, warranties or obligations under this Agreement.

10. NOTICES

All notices, demands or other communications required or permitted under this Agreement shall be in writing and delivered to the Parties at the addresses below by hand, certified mail, return receipt requested, or overnight courier.

11. AMENDMENT; WAIVER

No amendment or modification of this Agreement shall be effective unless in writing and signed by both Parties. The failure of either Party to enforce any provision of this Agreement shall not constitute a waiver of that provision or any other provision.

12. GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the state of without regard to conflict of laws principles.

13. ENTIRE AGREEMENT

This Agreement constitutes the entire agreement between the Parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, understandings and negotiations, whether written or oral.

14. SEVERABILITY

If any provision of this Agreement is held to be invalid, illegal or unenforceable in any respect, the validity, legality and enforceability of the remaining provisions shall not in any way be affected or impaired.

15. COUNTERPARTS; ELECTRONIC SIGNATURES

This Agreement may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one and the same instrument. Signatures transmitted by electronic means shall be deemed binding for all purposes.

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