Legal Settlement Worksheet

LEGAL SETTLEMENT WORKSHEET

This Legal Settlement Worksheet is entered into as of Effective Date: by and between Claimant Name: (Claimant) and Respondent Name: (Respondent).

RECITALS

WHEREAS, Claimant has asserted certain claims against Respondent arising from the facts and circumstances described as: occurring on or about ; and

WHEREAS, the parties desire to negotiate and record the principal settlement terms and conditions herein as a worksheet to guide preparation of a definitive settlement agreement and mutual release; and

WHEREAS, the parties acknowledge that this Worksheet is intended to memorialize material terms to be included in a binding settlement agreement, subject to the completion of agreed conditions precedent and execution of definitive documents.

NOW THEREFORE, in consideration of the mutual covenants set forth below and other good and valuable consideration, the parties agree to the following preliminary terms:

1. DEFINITIONS

For purposes of this Worksheet: (a) "Settlement Amount" means the gross monetary consideration described in Section 2; (b) "Release" means the mutual release of claims described in Section 4; and (c) "Definitive Agreement" means the formal Settlement Agreement and Mutual Release to be executed by the parties.

2. SETTLEMENT PAYMENT

Gross Settlement Amount payable by Respondent to Claimant (total): $ .

3. PAYMENT SCHEDULE & METHOD

Payment will be made as follows: . Anticipated first payment date: . Method of payment: .

4. RELEASES (BASIC TERMS)

Subject to receipt of the Settlement Amount in accordance with Section 3 and execution of the Definitive Agreement, Claimant will execute a full and final general release of all claims arising out of or related to the facts alleged in the underlying dispute, including known and unknown claims, which release shall be mutually binding as to both parties except as expressly reserved in the Definitive Agreement.

5. CONFIDENTIALITY & NON-DISPARAGEMENT

The parties agree that the terms, existence, and negotiations of this settlement shall be confidential and not disclosed to third parties except as required by law or to each party's legal and financial advisors who agree to be bound by confidentiality. Confidentiality required: Yes No

Non-disparagement: Yes No

6. TAXES AND WITHHOLDING

Responsibility for taxes: The parties agree that payment characterization and responsibility for taxes shall be allocated as follows: . Any required tax forms or withholding will be addressed in the Definitive Agreement.

7. COSTS, ATTORNEYS' FEES, AND LIENS

Payment of attorneys' fees and costs to be handled as follows: . Any asserted liens or subrogation claims to be addressed: .

8. CONDITIONS PRECEDENT

The obligations set forth in this Worksheet are subject to the following conditions precedent (list all that apply):

9. COURT DISMISSAL / FURTHER FILINGS

The parties anticipate that dismissal paperwork will be filed as follows: . Plaintiff's counsel to prepare dismissal: Yes No

10. REPRESENTATIONS, WARRANTIES, AND COOPERATION

Each party represents and warrants that it has full authority to settle the claims described, that the person executing the Definitive Agreement on behalf of each party is duly authorized, and each party agrees to cooperate and execute such further documents as may be reasonably necessary to effectuate the settlement.

11. INDEMNIFICATION

Except as expressly provided in the Definitive Agreement, neither party will have any further liability to the other for the matters released. Any indemnification obligations, if agreed, will be set forth in the Definitive Agreement: .

12. NOTICES

All notices required under the Definitive Agreement will be sent to the addresses below or to counsel of record. Claimant Notice Address:

13. AMENDMENTS; WAIVER; COUNTERPARTS

Any amendment to these preliminary terms must be in writing and signed by both parties. A waiver by either party of any breach shall not be deemed a waiver of any other breach. The Definitive Agreement may be executed in counterparts, each of which shall be deemed an original.

14. GOVERNING LAW

This Worksheet and any Definitive Agreement shall be governed by and construed in accordance with the laws of the State of without regard to its choice-of-law principles.

15. ENTIRE AGREEMENT

This Worksheet constitutes the complete expression of the preliminary settlement terms as understood by the parties. It supersedes all prior oral or written communications concerning the subject matter herein and will form the basis for the Definitive Agreement to be negotiated and executed by the parties.

16. SEVERABILITY

If any provision of this Worksheet is determined to be invalid or unenforceable by a court of competent jurisdiction, the remainder of the provisions shall remain in full force and effect and the invalid or unenforceable provision shall be reformed only to the extent necessary to make it enforceable.

ADDITIONAL NOTES

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