Employment Separation
Agreement
& General Release
ocstoc Legal Agreements
This Employment Separation Agreement & General Release can be
used by companies when they terminate their employee by offering
him or her extra severance pay.
ALL INFORMATION AND FORMS ARE PROVIDED “AS IS” WITHOUT ANY EXPRESS OR IMPLIED
WARRANTY, INCLUDING AS TO LEGAL EFFECT OR COMPLETENESS. They are for guidance and should be
modified by you or your attorney to meet your specific needs and the laws of your state. Use at your own
risk. Docstoc, its employees or contractors who wrote or modified any form, are NOT providing legal or any other
®
kind of advice and are not creating or entering into an Attorney-Client relationship. The information and forms
are not a substitute for the advice of your own attorney. Subject to our Terms of Service
(http://www.docstoc.com/popterm.aspx?page_id=15). See back cover page and read more here
(http://www.docstoc.com/popterm.aspx?page_id=114) for additional disclaimers and more. This document is
not approved, endorsed by, or affiliated with any State, or governmental or licensing entity.
Entire document © Docstoc, Inc., 2010, 2011
Attorney Drafted
© Copyright 2011 Docstoc Inc. registered document proprietary, copy not 1
EMPLOYMENT SEPARATION AGREEMENT & GENERAL RELEASE
THIS EMPLOYMENT SEPARATION AGREEMENT (hereinafter referred to as
“Agreement”) is made effective as of ______ [Month] ____ [Date], 20___ [Year], by and
between __________________________ [Instruction: Insert the name of the employee]
herein after referred to as the “Employee” and ___________________________ [Instruction:
Insert the name of company] including its members, owners, directors, agents, employees,
attorneys, assigns, and representatives hereinafter referred to as the “Company”.
WHEREAS the Employee has been employed as the _______________________ [Instruction:
Insert the designation of the Employee] from ____ [Month] ___ [Date], 20____ [Year];
WHEREAS the Employee is irrevocably separating from employment with the Company
effective ______ [Month] ____ [Date], 20___ [Year], hereinafter termed as the “Employment
Termination Date”.
WHEREAS it is the desire of the Company and the Employee to set forth herein their mutual
agreement with respect to all matters relating to (i) the Employee’s separation from employment
with the Company; and (ii) the Employee’s release of claims, all set forth herein;
NOW THEREFORE, for and in consideration of the mutual covenant and promises contained
herein, the parties hereby agree to as follows:
1. Termination of Employee.
Separation from employment was involuntary, occurring in connection with
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
[Instruction: Insert list of reasons. E.g., Reduction in workforce brought about by
economic conditions in the company’s marketplace, etc.] The Company agrees that
Employee is entitled to receive unemployment insurance benefits as a result of the
© Copyright 2011 Docstoc Inc. registered document proprietary, copy not 2
termination. Company specifically confirms that there was no misconduct on the part of
Employee, as the term “Misconduct” is defined for purposes of determining eligibility for
unemployment insurance benefits. [Optional]
2. Payment and Other Compensation. On Employment Termination Date, separately
from this agreement, the Company has paid to Employee unconditionally all wages
earned ________ ($___) [Instruction: Insert the wages earned, e.g., Five hundred
dollars only ($500)] through Employment Termination Date. Those payments were
made by checks, wire transfer, cash, or direct account deposit, which are separate from
the severance payment described later in this paragraph. Employee’s receipt of the
accrued wages and accrued vacation were not in any way dependent on his Agreement to
sign this Agreement in exchange for a severance payment.
3. Severance Payment. In addition to the foregoing, and in exchange for the mutual
promises contained in this agreement, Company agrees to pay to Employee upon his
signature of this Agreement a single severance payment in the gross amount of ________
($___) [Instruction: Insert the wages earned E.g., five thousand dollars only
($5,000)]. Employer will deduct from that gross amount the withholding amounts
required by state and federal law. As required by law, that amount will be included in
Employee’s gross earnings for calendar year 20____ [Instruction: Insert the calendar
year e.g., 2010].
4. General Release. In exchange for the promises of Company contained in this
Agreement, Employee hereby releases, acquits, and forever discharges the Company
and/or its parent corporation, subsidiaries, divisions, predecessors, successors, and
assigns, as well as past and present officers, directors, employees, shareholders, trustees,
joint ventures, partners, and anyone claiming through them herein after termed as the
“Released Parties” including their agents, employees, officers, and directors from all
claims, controversies, grievances, disputes, and actions of every kind, known or
unknown, vested or contingent, past or present, arising out of his employment at
Company. This release includes all claims for breach of contract, claims for defamation,
© Copyright 2011 Docstoc Inc. registered document proprietary, copy not 3
or for violation of civil rights, claims for harassment, retaliation, and/or discrimination
under the Civil Rights Act of 1964, the Family & Medical Leave Act, the National Labor
Relations Act, the Labor Management Relations Act, the Pregnancy Discrimination Act
and its state counterpart, claims arising through the date hereof under the Age
Discrimination in Employment Act of 1967 (as amended by the Older Workers Benefit
Protection Act), and its state counterpart, and claims under any other federal, state or
local statute, law, or regulation. Employee releases Released Parties from all claims
related to delivery or non delivery to him/her of any notice required by the Consolidated
Omnibus Budget Reconciliation Act (COBRA), concerning the Employee's right to
continued health and/or dental insurance benefits following his or her separation from
employment with Company. The Payment and Compensation amounts set out in
Paragraph 2, including the Severance Payment set out in Paragraph 3, are deemed by the
parties to exceed the amount of wages, salary, regular time pay, commissions, overtime
pay, premium pay, compensatory time, meal break penalties or wages, rest break penalty
or wages, penalties concerning the provision or non provision of itemized wage
statements, retaliation, and waiting time penalties, which are due to Employee and
unpaid.
5. Pending and Future Legal or Administrative Actions. Employee represents that there
are no actions, whether in court, before any agency, or otherwise, asserting claims by or
on behalf of Employee against any of the Released Parties, including but not limited to,
actions that concern allegations based on Employee’s employment with Company.
Employee agrees to file no action in the future concerning his employment with Released
Parties, or concerning this agreement.
6. Defense to Further Action. This Agreement shall constitute a full and complete defense
to, and may be used as a basis for an injunction against, any action, suit, or other
proceeding which may be instituted, prosecuted, or attempted by Employee in breach of
this Agreement. In the event that Employee institutes or is a party to any such action, that
claim shall be dismissed with prejudice and with an award of attorneys' fees and costs to
© Copyright 2011 Docstoc Inc. registered document proprietary, copy not 4
any party incurred as a result of such action, immediately upon presentation of this
Agreement.
7. Construction. This Agreement shall be governed by and construed in accordance with
the laws of the State of Alaska.
8. Entire Agreement. This Agreement constitutes the entire agreement of the parties with
respect to the subject matter of this Agreement.
9. Partial Invalidity. If any provision of this Agreement is held by a court of competent
jurisdiction to be invalid, void, or unenforceable, the remaining provisions shall
nevertheless continue in full force without being impaired or invalidated in any way.
10. Execution. This Agreement may be signed in counterparts and on separate signature
pages. These separate signature pages will become part of the integrated Agreement.
Where convenient for the parties to do so, the signed signature pages may be facsimile
transmissions.
11. Thorough Review. Employee hereby acknowledges that he has carefully read all of the
terms of this Agreement. Employee acknowledges that he had the opportunity (at his own
expense) to consult counsel in the discussion and negotiation of this settlement agreement
and either did so or voluntarily declined that opportunity.
© Copyright 2011 Docstoc Inc. registered document proprietary, copy not 5
The effective date of this Agreement is the date of signature by Employee.
For Company:
_________________________________ ______ [Month] ___ [Date], 20___ [Year]
[Instruction: Insert the signature of company representative]
_________________________________
Name and Designation
By Employee:
_____________________________ ______ [Month] ____ [Date], 20___ [Year]
[Instruction: Insert the signature of employee]
____________________________
Name and Designation
© Copyright 2011 Docstoc Inc. registered document proprietary, copy not 6
Note: Carefully read and follow the Instructions and Comments contained in this document for
your customization to suit your specific circumstances and requirements. You will want to
delete the Instructions and Comments from open bracket (“[“) to close bracket (“]”) after
reading and following them. You (or your attorney) may want to make additional modifications
to meet your specific needs and the laws of your state
◊Where within this document you see this symbol: ◊ or an instruction states “Insert any number you choose◊,”
or something similar, or there is a blank for the user to complete, please note that although Docstoc believes the
information or number may be any that the user chooses, and that there is no law governing what the
information or number should be, you might want to verify this, including by consulting with your own attorney
practicing in your state, and be reasonable.
INFORMATION AND FORMS ARE PROVIDED "AS IS" WITHOUT ANY EXPRESS OR IMPLIED WARRANTY
OF ANY KIND INCLUDING WARRANTIES OF MERCHANTABILITY, NONINFRINGEMENT OF
INTELLECTUAL PROPERTY, OR FITNESS FOR ANY PARTICULAR PURPOSE. IN NO EVENT SHALL
DOCSTOC, INC., OR ITS AGENTS, OFFICERS, ATTORNEYS, ETC., BE LIABLE FOR ANY DAMAGES
WHATSOEVER (INCLUDING, WITHOUT LIMITATION, DAMAGES FOR LOSS OF PROFITS, BUSINESS
INTERRUPTION, LOSS OF INFORMATION) ARISING OUT OF THE USE OF OR INABILITY TO USE THE
MATERIALS, EVEN IF DOCSTOC HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.
Your use of this document is deemed to be your agreement to the foregoing, the disclaimers on the cover page,
and that you have read and agree to our Terms of Service
(http://www.docstoc.com/popterm.aspx?page_id=15), as well as our disclaimer that Legal information is not
legal advice, and the important content available here: Read More
(http://www.docstoc.com/popterm.aspx?page_id=114)
"Docstoc is unable to and does not provide legal advice, and please further note that laws change and are
regularly amended, therefore, the names and section numbers of statutes within this document may not be
100% correct as they may be partially or wholly out of date and some relevant ones may have been omitted or
misinterpreted. You may wish to consult with your own attorney practicing in your state to confirm the
accuracy of statutory references."
© Copyright 2011 Docstoc Inc. registered document proprietary, copy not 7