SETTLEMENT FOR RELEASE OF CLAIMS 

FOR AND IN CONSIDERATION OF THE SUM OF $____.___,
I ______________________________________________________________ (Aggrieved Party’s Name Here)
located at the following address of ________________________________________________________ as the aggrieved party hereby acknowledge for settlement and full release of all liability forever discharging:
_______________________________________________________________ (Aggravating Party Name Here)
located at the following address of  _______________________________________________________, their heirs, executors, administrators, agents and assigns, and all other persons, firms or corporations liable or who might be claimed to be liable,(collectively the “Releases”) from any and all claims, demands, damages, actions, causes of action of any kind or nature whatsoever that I now have or may hereafter have arising out of, in consequence of or on account of all injuries, known and unknown, to person and property, including any latent injuries and all developments and results arising therefrom, whether known or unknown injuries, whether developed or undeveloped, and anticipated or unanticipated consequences of all such injuries, and damages resulting to me from the incident which occurred on or about the __________ day of __________, 20 __, at or near ____________________________________ involving the aggravating party, in so which I was the aggrieved party. By accepting the above mentioned sum, I hereby release and discharge all claims and agree to take part in no actions arising from said incident including testifying, affidavits, criminal or civil proceedings and agree that I am satisfied in full from all parties responsible for my damages. I hereby declare that I have fully read and understand the terms of this settlement and I have voluntarily accepted for the purpose of making a full and final compromise adjustment and settlement of any and all claims to avoid court action making all parties whole.
IN WITNESS WHEREOF I have executed this Release on __________ day of __________, 20 __ _____________________________
(Signature)
_____________________________
(Name Printed) _____________________________
(Witness Signature)
_____________________________
(Witness Name Printed)