Fill and Sign the Settlement Filing Form

Settlement Agreement and Release in Wrongful Death Suit after Filing of Suit but Prior to Trial This Settlement Agreement and Release _______________________________________ (Settlement Agreement) is entered into as the _____________________________ (Date) by ________________________________________ (Name of Plaintiff) , individually and the (e.g., wife or husband) ___________________________ of the late ___________________________ (Name of Decedent) , the Decedent , and by ___________________________________ (Name of Plaintiff) , as _______________________________________ (Name of Executor or Administrator) of the Estate of _____________________________ (Name of Decedent), collectively, the Releasor; and ________________________________ (Name of Defendant), the Releasee . Whereas, Plaintiff filed a complaint against Defendant and others in the______________ ____________________________________ (Name of Court), __________________________ (Name of County and State) in Civil Action No. _________________ (the Complaint), which Complaint arose out of certain alleged negligent acts or omissions by Defendant and others; and Whereas, in the Complaint, Plaintiff sought to recover monetary damages as a result of that certain occurrence on or about the ___________________________________ (date), which resulted in the death of Decedent; and Whereas the parties desire to enter into this Settlement Agreement in order to discharge all claims which are, or might have been, the subject matter of the Complaint as to Defendant , upon the terms and conditions set forth below; 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. Releasee shall pay to Releasor the sum $_______________in full settlement of all claims that Releasor now has or may subsequently have against Releasee for the death of Decedent or for any act or omission concerning the incident that resulted in the death of Decedent. 2. It is understood and agreed that this Settlement Agreement expresses a full and complete settlement of any and all liability, which has been denied by the Releasees, and is not now admitted, and regardless of the adequacy of the compensation to be paid under this Settlement Agreement it is intended to avoid any possible further litigation. It is understood that the Releasees , their heirs, executors, administrators, personal representatives, agents, servants, employees, employers, insurers, successors, and assigns, by reason of this payment, do not admit any liability, nor have they made any agreement to make any payment or to take any action not reflected in this Settlement Agreement . 3.Each party hereto shall bear all attorney’s fees and costs arising from the act ions of its own counsel in connection with the Complaint, the Settlement Agreement , and the matters and documents referred to herein, the filing of a Dismissal of the Complaint, and all related matters. 4. Concurrently with the execution of this Settlement Agreement, counsel for the Plaintiff shall deliver to Defendant an executed Dismissal with Prejudice of the Complaint as to Defendant . Plaintiff hereby authorizes Defendant to file said Dismissal with the Court and enter it as a matter of record.5. In entering into this Settlement Agreement , the Plaintiff represents that Plaintiff has relied upon the advise of Plaintiff’s attorneys and that the terms of this Settlement Agreement have been completely read and explained to Plaintiff by Plaintiff’s attorneys; and that the terms of this Settlement Agreement are fully understood and voluntarily accepted by Plaintiff. 6. Plaintiff represents and warrants that no other person or entity has, or has had, any interest in the claims, demands, obligations or causes of actions referred to in this Settlement Agreement, except as otherwise set forth herein; and that Plaintiff has the sole right and exclusive authority to execute this Se ttlement Agreement and receive the sum specified in it; and that Plaintiff has not sold, assigned, transferred, conveyed or otherwise disposed of any claims, demands, obligations, or causes of action referred to in this Settlement Agreement. 7. This Settlement Agreement shall be construed and interpreted in accordance with the laws of the ________________________.8. All parties agree to cooperate fully and execute any and all supplementary docume nts and to take all additional actions which may be necessary or appropriate to give full force and effect to the basic terms and intent of this Settlement Agreement. 9. This Settlement Agreement contains the entire agreement between the Plaintiff and the Defendant and shall be binding upon and inure to the benefit of the executors, administrators, personal representatives, heirs, successors and assigns of each.10. This Settlement Agreement shall become effective following execution by all parties. IN WITNESS WHEREOF, the parties hereto have duly executed this Settlement Agreement in multiple originals. Date: _____________________________ Executor 1 of the Estate of Decedent By: ________________________________ ___________________________________ (Printed Name & Signature) 1 Administrator may be correct term if the Decedent had no will. Date: __________________________________________________________ ___________________________________ (Printed Name & Signature of Spouse) Oath or Acknowledgment of Each (depending upon jurisdiction) APPROVED AS TO FORM AND CONTENT: Date: __________________________ ______________________________ Attorney for Plaintiff Date: _________________________ ______________________________ Attorney for Defendant