Release of Liability Form (Car Accident)

Whose names do you want to add to this form?

Both parties to the accidentOnly the releasor (the person waiving their right to sue)Only the releasee (the person at risk of being liable)I don't know either individual's name

Releasor's name:

This is the person who is waiving their right to sue or make future claims against the other party.

Releasee's name:

This is the party who is at risk of being sued by the Releasor.

What date did the car accident occur on?

Do you want to add additional details about the accident? (OPTIONAL)

Do you want to add additional details about the accident? (OPTIONAL) YesNo

Additional Info

Add the TIME of the accident?

Add the TIME of the accident? YesNo

Time of accident:

Add the LOCATION of the accident?

Add the LOCATION of the accident? YesNo

Where did the accident occur?

Do you know how much the settlement amount is?

Do you know how much the settlement amount is? YesNot yet

Settlement amount:

Do you want to enter the Releasor's mailing address at this time?

Do you want to enter the Releasor's mailing address at this time? YesNo, I'll do this later

Releasor's mailing address:

Street Address

Address Line 2

City

State

ZIP Code

Do you want to enter the Releasee's mailing address at this time?

Do you want to enter the Releasee's mailing address at this time? YesNo, I'll do this later

Releasee's mailing address:

Street Address

Address Line 2

City

State

ZIP Code

Do you want to enter the date of this agreement?

Do you want to enter the date of this agreement? YesNo, I'll do this later

Agreement date:

Save and finish later