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Statement Of Attorney--Releasor
STATEMENT OF ATTORNEY--RELEASOR
I, [Name of Attorney], Attorney at Law, with a law office at [Address of Attorney], declare that I am the attorney for [Name of Releasor], releasor in the above release, that I have explained to my client all the terms of the release, and that my client has represented to me that [he or she] fully understands all the terms and their significance. [Name of Releasor], my client, has signed the release on my advice.
Signature Date
[Bar number if required]