Fill and Sign the Settlement Agreement and Release Federal Lexisnexis Form

1 Settlement Agreement and Release (Lawsuit not Filed) This Settlement Agreement and Release (the Settlement Agreement) is made and entered into this ____________________________ (date) by and between _______________________ (Name of Releasor) of __________________________________________________________ ________________________________________ (street address, city, county, state, zip code), hereinafter called Releasor, and _______________________________ (Name of Releasee) of _____________________________________________________________________________________________________________________ (street address, city, county, state, zip code), hereinafter called Releasee. Whereas, on ___________________________ (date), Releasor and Releasee were involved in a automobile accident at _______________________________________________ (location of accident) while Releasor was driving a ___________________________________ ____________________________________ (describe automobile) and Releasee was driving a ____________________________________________________________________ (describe automobile); and Whereas, as a result of said accident, Releasor sustained damages to said automobile, incurred medical expenses, missed worked and suffered other damages related to said accident; and Whereas, the parties desire to enter into this Settlement Agreement in order to provide for certain payments in full settlement and discharge of all claims which are, or might have been made, brought by Releasor against Releasee for negligence or any other wrongful act of Releasor which was the proximate cause of any damages sustained by Releasee as a result of said accident. Now, therefore, for and in consideration of the mutual covenants contained in this agreement, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties agree as follows: 1. In consideration of the payment of $______________, Releasor hereby completely releases and forever discharges Releasee from any and all past, present or future claims, demands, obligations, actions, causes of action, wrongful death claims, rights, damages, costs, losses of service, expenses and compensation of any nature whatsoever, whether based on a tort, contract or other theory of recovery, which the Releasee now has, or which may hereafter accr
Pt, be filed or may hereafter be brought against, or on behalf of, releaser or released. 2. In consideration of the release, releaser and releasee are forever bound by the following covenant and release: 1. It is the condition of your participation in, and acceptance of this settlement agreement that the undersigned party will comply with all laws, contracts and agreements contained in this agreement and its accompanying paper form. 2. The undersigned party assumes full and complete responsibility for his or her activities in the event of any breach of his or her obligations above and shall not be held liable by the undersigned party for any such breach. 3. It is the understanding of the undersigned that the undersigned party will not, and as such hereby disclaims any liability to releaser and releasee by reason of any act or omission to the contrary, including any failure to do as required by other parties. 4. To the fullest extent authorized by applicable state law including the requirements of the federal motor vehicle safety act of 1986, the undersigned party and his successors, assigns, authorized attorneys or agents disclaim all present and future claims and/or demands arising out of, or related to, any negligence of the undersigned party or such other acts and omissions committed while releasing or releaser. 5. The undersigned party hereby confirms and declares that when this agreement and release is executed and recorded by legal representatives of the parties, or when a signature or other acknowledgment is made by any person other than the undersigned party, the undersigned party acknowledges, accepts, and agrees that the undersigned party is the proper and sole released of his/her claim against releasee for negligence, and no other claims, demands, obligations, actions, causes of action, wrongful death claims, rights, damages, costs, losses of service, expenses or compensation of any nature whatsoever, whether based on a tort, contract or other theory of recovery are or are not pending or being filed against releaser, released or any of them at this time. 6. The undersigned party hereby acknowledges that he/she and released are mutually aware of the risks and dangers inherent in this activity and that the released and releaser have a full and perfect right to know the risks and dangers involved with their involvement in this activity. 7. The undersigned party, irrevocably acknowledges and accepts the risk of injury, death and/or property damage to the released and releaser