Fill and Sign the Statute Form

AGREEMENT TO TOLL STATUTE OF LIMITATIONS This agreement is made by and between       , and       (hereafter sometimes referred to as “       ”) and       and       . (hereafter referred to as “       ”), and is made in reference to the following facts: a.       believe they may have       claims against       arising from       . b. So as to allow       an opportunity to assess and determine the legitimacy and viability of their claims and to further determine if they have incurred or suffered damages arising out of defendants alleged negligence,       desire to withhold the filing or initiation of any claim, action or lawsuit by them (or either of them) against       for an agreed period of time. c.       are agreeable to providing       with additional time to assess and determine the legitimacy and viability of their claims and/or the amount of their damages without the necessity of filing an action. Therefore, the parties, in exchange for the promises made herein, and for good and sufficient consideration, agree as follows: 1. Commencing       and for the duration of this Agreement, the parties agree that all applicable statute of limitations as to any and all claims that       (or either of them) may have against       , in connection with, related to, or arising from the Legal Matters, shall be tolled and suspended during the period of time this Agreement is in effect. 2. The parties hereby waive any defense by way of any statute of limitations which would otherwise arise during such period. 3. This waiver shall not be construed as a waiver of any statute of limitations defense that has become established as of the effective date of this Agreement, or which would arise after the date of termination of this Agreement, excluding the period during which this Agreement has operated to toll any applicable statute of limitations. 4. The running of all applicable statute of limitations shall commence again on the termination of this Agreement, unless there is an extension of this tolling Agreement executed in writing by and on behalf of the parties hereto. 5. Upon termination of this Agreement, or termination of any written extension thereof, the parties shall be returned to the status quo as of the effective date of this Agreement. 6. It is understood that by entering into this Tolling Agreement, neither party is waiving any claims, rights or defenses that may have accrued up to the effective date of this Agreement. Further,       entering into this agreement is not, and shall not be construed as any admission or acknowledgment that all persons or entities identified as “       ” are in any way liable to       for       . 7. The effective date of this agreement is       . This Agreement will terminate on       unless extended in writing by the parties hereto. However, either party may terminate this agreement at any time, by providing notice of intent to terminate in writing addressed to the party at the address indicated below. Notice shall be done by Certified or Registered Mail. The effective date of termination given by written notice shall be 30 days beyond the date notice is given. 8. This Agreement shall not be offered in evidence in any action or proceeding except to prove that the statute of limitations was tolled for the period of time during which this Agreement was in effect. 9. This agreement may be signed in counterpart originals, but a faxed signature hereon by either party shall be effective for all purposes. Dated:             Signature Dated:             Signature Dated:             Signature Dated:             Signature 2