Sample Release

Release of all Claims

FOR AND IN CONSIDERATION of the payment to me/us at this time of the sum of $275,000 the receipt of which is hereby acknowledged, I/We, being of lawful age, do hereby release, acquit and forever discharge Francis Mueller and all other persons, firms and corporations who might be liable of and from any and all actions, causes of action, claims, demands, damages, costs, loss of services, expenses and compensation, on account of, or in any way growing out of, any and all known and unknown personal injuries and property damage resulting or to result from an accident that occurred on or about the 19th day of July, 2011 at or near Chester Street and Madison Street Baltimore, Maryland.

I/We hereby declare and represent that the injuries sustained are permanent and progressive and that recovery therefrom is uncertain and indefinite, and in making this release and agreement it is understood and agreed that I/We rely wholly upon my/your own judgment, belief and knowledge of the nature, extent and duration of said injuries, and that I/We have not been influenced to any extent whatever in making this release by any representations or statements regarding said injuries, or regarding any other matters, made by the persons, firms or corporations who are hereby released, or by any person or persons representing him or them, or by any physician or surgeon by him or them employed.

It is further understood and agreed that this settlement is the compromise of a doubtful and disputed claim, and that the payment is not to be construed as an admission of liability on the part of Francis Mueller, by whom liability is expressly denied.

I/We further agree that this release shall not be pleaded by me/us as a bar to any claim or suit.

This release contains the ENTIRE AGREEMENT between the parties hereto, and the terms of this release are contractual and not a mere recital.

I/We further state that I/We have carefully read the foregoing release and know the contents thereof, and I/We sign the same as my/our own free act.

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