Car Accident Release of Liability Form (Settlement Agreement)

The Releasor is RELEASING someone else. The party usually receiving a payment.

Releasor's Name

Individual or Company Name

The Releasee is BEING RELEASED. This is usually the party making a payment.

Releasee's Name

Individual or Company Name

Accident Details

What DAY did the accident occur?

In exchange for this release, the Releasor has accepted what type of consideration?

Money ($) PaymentGoodsOtherNone

A Release is typically given after the releasee has paid some type of consideration for the damages caused in the accident.

Enter Amount

$

Describe Goods given in exchange for the Release

Other (Please Specify)

Date of this Agreement

Usually today's date.