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Back to Forms for 'Releases and Settlements'.




This mutual release, executed on __________ (date), between ____________________

________________________________________ (name) of _____________________

_______________________________________ (address), and ___________________

_______________________ (name), of ______________________________________

(address), is intended to effect the extinguishment of obligations as herein designated, ___________ (as provided by _________________________ (cite statute that specifies legal consequences of a release)).




A.  Disputes and differences have arisen between the parties with respect to the following described event that occurred on __________ (date):  ___________________

______________________________________________________________ (specify event) or that certain contract entered into by the parties on ___________ (date), a copy of which is attached hereto and made a part hereof or as the case may be).


B.  The parties have agreed to execute this mutual release in settlement of such disputes and differences.


In consideration of the mutual relinquishment of their respective legal rights with reference to the above-mentioned disputes and differences, in consideration of the execution of this mutual release, and in consideration of the payment by ________________________________ (name) to ______________________ (name) of $ __________, receipt of which by _______________________________ (name) is acknowledged, each party, for __________ (himself or herself or himself and herself or as the case may be) and __________ (his or her or his and her or as the case may be) heirs and legal representatives, expressly releases the other, and __________ (his or her or his and her or as the case may be) heirs and legal representatives, from all liability for claims and demands arising out of the above-described _______________________ (event or contract or as the case may be).


In witness whereof, the parties have executed this mutual release at ________________ ____________________ (designate place of execution) on the day and year first above written.



_____________________________________                   _______________________

Signature                                                                               Date



_____________________________________                   _______________________

Signature                                                                               Date




(Attach copy of contract)


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