Claim Settlement Agreement 201112613

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Claim Settlement Agreement 201112613 Powered By Docstoc
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                           Claim Settlement Agreement

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                                  FIRST PARTY
Name:



Address



City                              State                       Postal/ZIP Code




Phone                             Fax                               Email




                      ☐ Individual                     ☐ Corporation
                                SECOND PARTY
Name:



Address



City                              State                       Postal/ZIP Code
Phone                                  Fax                            Email




                        ☐ Individual                   ☐ Corporation
                                       SETTLEMENT
In full and complete settlement of any and all claims under the laws of any applicable
jurisdiction, First Party shall pay $____________ to Second Party related to or arising
from the claim referred to herein.
                        ☐ Yes                         ☐ No

Said settlement shall also include any attorney’s fees or claim/litigation expenses.
                        ☐ Yes                         ☐ No

This release shall also inure to the benefit of _____________________.


This release shall be contingent upon the approval of the ________________.
                        ☐ Yes                         ☐ No

Upon final approval, which shall be defined as an approval for which no further review is
possible, payment shall be made.
                        ☐ Yes                         ☐ No

In the event that the settlement is not approved this agreement shall be void and of no
effect.
                        ☐ Yes                         ☐ No

This is the entire agreement between the parties and may only be varied by a writing
executed by the parties.
                        ☐ Yes                         ☐ No
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