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Release From Liability To Estate
RELEASE FROM LIABILITY TO ESTATE
Release executed on [date of execution], by [name of administrator or executor], of [address of releasor], here referred to as releasor, to [Name of releasee] of [address of releasee], here referred to as releasee.
In consideration of the sum of $ [Amount paid] Dollars, paid by releasee to releasor, receipt of which is hereby acknowledged, releasor, as [administrator or executor] of the Estate of [name of deceased], deceased, releases and forever discharges releasee, and his or her heirs and legal representatives from all claims, demands and causes of action of every kind, arising from or connected with the accident that resulted in the fatal injury to [name of decedent], which accident is described as follows:
[description of accident].
Payment of the consideration for this release shall not be construed as an admission of liability by releasee. The release is intended and executed for the purpose of fully and forever compromising, discharging and releasing all claims of every kind, character and description in favor of releasor and the Estate of [name of decedent] against releasee, based on the above-described accident or death of [name of decedent].
In witness whereof, this release is executed by releasor, as [administrator or executor], at [designate place of execution] the day and year first above written.
Signature Date