GENERAL RELEASE

BE IT KNOWN, that ________(1)_________, (hereinafter referred to as "Releasor"), for and in consideration of the sum of _________(2)_________ ($_________) Dollars, and other valuable consideration received from or on behalf of _________(3)________, (hereinafter referred to as "Releasee"), the receipt of which is hereby acknowledged, does hereby remise, release, acquit, satisfy, and forever discharge the said Releasee, of and from all manner of actions, causes of action, suits, debts, covenants, contracts, controversies, agreements, promises, claims and demands whatsoever, which said Releasor ever had, now has, or which any personal representative, successor, heir or assign of said Releasor, hereafter can, shall or may have, against said Releasee, by reason of any matter, cause or thing whatsoever, from the beginning of time to the date of this instrument.

IN WITNESS WHEREOF, the said Releasor has hereunto set hand and seal this _(4)_ day of ________(5)_________, 19_(6)_.

Signed, sealed and delivered in the presence of:

"RELEASOR"

_____________(7)________________ _____________(8)_______________

_____________(7)________________

STATE OF ________(9)________

COUNTY OF _______(10)_______

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