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Release executed on __________ (date), by __________________________________ (name), of ____________________________________________________ (address), here referred to as releasor, to _______________________________________ (name), a corporation incorporated under the laws of the State of __________________, having its principal place of business at ____________________________________________ (address), here referred to as company.




A.  A certain contract of employment was entered into between releasor and company on __________________ (date).  A copy of the contract is attached hereto and made a part hereof.


B.  Releasor asserts that company has breached the contract in that ________________ (set forth nature of breach), and that, as a result of such breach, releasor has suffered damages in the aggregate amount of ____________ Dollars ($__________ ), itemized as follows: ___________________________________________________________________



C.  Company asserts that it has not breached the contract or, in the alternative, that if it has breached the contract, damages sustained by releasor amount to no more than _____________________ Dollars ($__________ ).


D.  Releasor is willing to release company from all past and present claims based on the contract, on the terms set forth herein.




In consideration of __________ Dollars ($___________ ) paid to releasor by company, receipt of which is acknowledged, releasor, for _____________ (himself or herself) and _____________ (his or her) heirs, legal representatives and assigns, releases and forever discharges company, its successors and assigns, of and from all claims, demands, actions and causes of action of any kind or nature at law or in equity, based on the above-mentioned contract. This release applies to all past and existing claims, including, without limitation, such rights of releasor under the contract as __________

_______________________________________ (list rights of employees, including basic compensation and fringe benefits).


In witness whereof, the parties have executed this release agreement at ___________

_____________________________ (designate place of execution) the day and year

first above written.



____________________________                         ___________________

Signature                                                                   Date



____________________________                         ___________________

   Signature                                                                   Date



(Attach copy of employment contract)




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