This is an agreement between a company and a former employee that sets forth the
separation terms of the former employee. The former employee will receive a
severance package and continue to receive benefits. In exchange, the former
employee must agree to release the company against all potential claims in the future.
This document contains numerous standard provisions that are commonly included in
these types of agreements, and may be customized to fit the specific needs of the
contracting parties. This agreement can be used by small businesses or other entities
that want to provide former employees with a severance package in a return for a
release of all claims.
SEPARATION AND RELEASE AGREEMENT
This Separation and Release Agreement (hereinafter the “Agreement”) is made on this ____ day
of ___________ of ________ by and between __________________ [Comment: insert
Company name and address] (hereinafter “Company”) and ___________________________
[Comment: insert Employee name and address] (hereinafter “Employee”).
Employee was associated with Company in the position of _____________ [Comment: insert
job title]. Employee and Company have mutually agreed to amicably terminate the Employee-
As of _____________ [Comment: insert date], Employee’s relationship with Company has
II. SEVERANCE ALLOWANCE AND BENEFITS
In consideration of Employee’s agreement to the terms and releases contained in the instant
Agreement, Company will pay Employee a severance allowance in the total amount of
_____________ dollars ($_____________). Payment will be made on a payment schedule that
is consistent with Employee’s current payment schedule at a rate of _____________ dollars
($__________) per month for _______ (__) months.
Company shall continue to pay Employee’s medical coverage benefits, pursuant to the
Consolidated Omnibus Budget Reconciliation Act of 1985 (hereinafter “COBRA”), under
________________ [Comment: insert health insurance plan name].
If requested by Employee, Company will pay for a job referral and outplacement service to assist
Employee in locating future employment. Company will pay for this service for a period of
_______ (__) months after Employee’s termination or until such time as Employee secures new
Employee agrees to irrevocably and unconditionally release, acquit and forever discharge
Company and/or its assigns, successors, parent corporation, subsidiaries, divisions, and
predecessors, including its past, present and future officers, employees, directors, shareholders,
partners, and joint venturers, and any claims made through same (hereinafter “Releasees”), in
Releasees’ corporate and/or individual capacities from any and all promises, actions, claims,
liabilities and damages, both known and unknown, which Employee has or had against same
relating to or arising from Employee’s position with Company or the termination of Employee
from his/her position.
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Employee hereby warrants that he/she not bring any legal action against any of the
aforementioned Releasees for any claims released under this Agreement and further represents
that no similar or related claims have been filed as of the effective date of this Agreement.
Employee further agrees to cooperate completely and fully with Company in the event that
Company faces any administrative, judicial, or similar proceedings.
Employee agrees to not make any comments or statements that would prove to be derogatory to
Company or Company’s business or financial arrangements.
If Employee breaches any of the aforementioned terms and releases, Employee must return all
accrued severance pay to Company. All future payments will terminate immediately.
This Agreement shall be binding on the parties, their heirs, administrators, representatives,
executors, successors and assigns and shall inure to their benefit and to that of their heirs,
administrators, representatives, executors, successors, and assigns.
This Agreement constitutes the entire agreement between the parties as to the subject matter
herein, supersedes any and all prior agreements and understandings, and sets forth both parties
entire understanding of all relevant subject matter.
This Agreement shall not be amended, altered, modified, or waived without the express written
consent of both parties.
Any delay by Company in enforcing any of its rights under this Agreement will not be deemed a
waiver of those rights.
Employee hereby agrees to return to Company any confidential materials, property, or company
documents within Employee’s possession, recognizing that failing to do so may subject
Employee to prosecution under relevant statutes.
Employee agrees to keep the terms of this Agreement confidential and to only discuss
Agreement specifics with his or her respective legal and financial counsel, recognizing that
failing to do so will require relinquishment of all monies paid to Employee under this