Sample Settlement Agreement And Release Page 15
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16CLAIMANT:
I HAVE READ THIS SETTLEMENT AGREEMENT AND RELEASE AND,
UNDERSTANDING ALL OF ITS TERMS, I SIGN IT AS MY FREE ACT AND DEED.
Date____________________ __________________________________________________
Claimant
__________________________________________________
State of _____________________
(SS)
County of ___________________
On this _______ day of _______ in the year _______, before me, the undersigned notary public,
personally appeared _________________________, known to me to be the person(s) whose
name(s) is/are subscribed to the within instrument and acknowledged that he/she/they executed
the same for the purposes therein contained. In witness whereof, I hereunto set my hand and
official seal.
_______________________________
Notary Public
Page 12 of 13
Initials __________ Initials ___________________________________
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