Release For Property Damage In Auto Accident (Fillible) Page 2
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3not assigned any claim arising from the accident described in Clause 2 to any other party.
This release applies to Releasee's heirs, legal representatives, insurers, and successors, as
well as to Releasee.
_________________________________________ __________________
Releasor's signature
Date
_________________________________________ __________________
Print name
County of residence
_________________________________________ __________________
Releasor's spouse's signature
Date
_________________________________________ __________________
Print name
County of residence
_________________________________________ __________________
Releasee's signature
Date
_________________________________________ __________________
Print name
County of residence
_________________________________________ __________________
Releasee's spouse's signature
Date
_________________________________________ __________________
Print name
County of residence
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Parent category: Legal