NOTICE OF RELEASE RESCISSION
To: ___________________________________ (name) _____________________________________ (address)
Notice is hereby given that the undersigned, ____________________________ (name), rescinds the release executed by __________ (him or her) on _______________ (date), releasing _____________________________ (name) from all claims arising out of: ____________________________________________________________________ ____________________________________________________________________ ___________________ (summary of claim with respect to which release was executed) on the ground that: _____________________________________________________ ____________________________________________________________________ ____________________________________________________________________ _______________________________________ (recite facts giving rise to rescission).
The undersigned offers to restore to ______________________ (name) all consideration received for the release, including ______________________________ _________________________________________ (specify consideration received).
_____________________________________ Signature
_______________________ Date