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163.d81
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2022-08-26
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982b
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35 lines
" For good and valuable consideration, \b and the
"heirs, successors, and assigns of the undersigned hereby releases
"forever discharges \a, his/her heirs, successors, and assigns from any
"and all claims, debts, demands, liabilities, and causes of action
"arising from: \c
"
" This release applies only to the foregoing obligation, and no
"other liability by and between the parties, any of which, if existing,
"shall survive this release. Signed on this \d day of \e, \f.
"
"
" \z DATE: \z
" (\b)
"
"
"
"STATE/COMMONWEALTH OF \z COUNTY/BOROUGH/PARISH OF \z
"
"BEFORE ME, the undersigned authority, on this day personally appeared
"\a, known to me to be the person(s) whose name(s) is(are) subscribed
"to the foregoing instrument, and acknowledged to me that he(she)(they)
"executed said instrument for the purposes and consideration therein
"expressed.
"GIVEN under my hand and seal of office on this \j day of \k, \l
"\m
"Notary Public's Signature
"(seal/stamp)