In this form, as a result of a lump sum settlement, a former employee is releasing a former employer from any and all claims for breach of contract or wrongful termination as well as any claim under the Employee Retirement Income Security Act of 1974, as amended (ERISA); any claim under the Age Discrimination in Employment Act, as amended, or the Older Workers Benefit Protection Act; any claim under Title VII of the Civil Rights Act of 1964, as amended; any claim under the Americans with Disabilities Act, as amended; and any other claim of discrimination or retaliation in employment (whether based on federal, state or local law, statutory or decisional);
This form is a generic example that may be referred to when preparing such a form for your particular state. It is for illustrative purposes only. Local laws should be consulted to determine any specific requirements for such a form in a particular jurisdiction.
Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.
