(Specifically waiving an age discrimination claim)

TO: Severed Employee
FROM: The Company ("The Employer")
RE: Older Workers Benefit Protection Act

This communication apprises you of your rights under the Older Workers Benefit Protection Act ("OWBPA") which amends the Age Discrimination in Employment Act ("ADEA"), that Congress passed. The OWBPA establishes certain standards as regards waivers that the Employer obtains from its Employees.

The OWBPA amends the ADEA by adding a new section which establishes standards for a "knowing and voluntary" waiver. The OWBPA sets forth seven basic requirements for a knowing and voluntary waiver:

(1) The waiver has to be part of an agreement between the Employee and the Employer and it has to be written in understandable English;

(2) The waiver must refer specifically to rights or claims arising under the ADEA;

(3) The waiver cannot cover rights or claims that may arise after the date on which it is signed;

(4) The waiver must be exchanged for consideration, and the consideration must be in addition to anything of value to which the employee is already entitled;

(5) The Employee must be advised in writing to consult with an attorney before signing the agreement;

(6) The Employee has to be given a period of at least 21 days to decide whether to sign the waiver; and

(7) The Employee is entitled to revoke the waiver within seven days after signing it, and the waiver does not become effective or enforceable until the revocation period has expired.

GENERAL RELEASE

FOR GOOD AND VALUABLE CONSIDERATION, the adequacy of which is hereby acknowledged, in the form of payment to Employee of a severance benefit in the amount of ($XX) salary less withholding for federal and state taxes, FICA and any other amounts required to be withheld, Employee agrees that he/she, or any person acting by, through or under Employee, RELEASES AND FOREVER DISCHARGES [Name of Employer], and its parent company and its subsidiaries, affiliates, predecessors, successors, and assigns, as well as the officers, employees, representatives, agents and fiduciaries, de facto or de jure (hereinafter collectively referred to as "Released Parties"), and covenants and agrees not to institute any action or actions, causes or causes of action (in law unknown) in state or federal court, based upon or arising by reason of any damage, loss, or in any way related to Employee's employment with any of the Released Parties or the termination of said employment. The foregoing includes, but not by way of limitation, all claims which could have been raised under common law, including retaliatory discharge and breach of contract, or statute, including, without limitation, the Age Discrimination in Employment Act of 1967, 42 U.S.C. Sections 621–634, as amended by the Older Workers Benefit Protection Act of 1990, Title VII of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000e et. seq. and the Employee Retirement Income Security Act of 1974, 29 U.S.C. Sections 1001 et. seq. or any other Federal or State Law; except that this General Release is not intended to cover any claim arising from computational or clerical errors in the calculation of the severance benefit provided to Employee, or retirement benefit to which Employee may be entitled from any plan or other benefits to which Employee may be entitled under any plan maintained by any of the Released Parties.

Employee covenants and agrees to forever refrain from instituting, pursuing, or in any way whatsoever aiding any claim, demand, action or cause of action or other matter released and discharged herein by Employee arising out of or in any way related to Employee's employment with any of the Released Parties and the rights to recovery for any damages or compensation awarded as a result of any lawsuit brought by any third party or governmental agency on Employee's behalf.

Employee further agrees to indemnify all Released Parties from any and all loss, liability, damages, claims, suits, judgments, attorneys' fees and other costs and expenses of whatsoever kind or individually, Employee may sustain or incur as a result of or in connection with the matters hereinabove released and discharged by Employee. Employee warrants that he/she has not filed any lawsuits, charges, complaints, petitions, or accusatory pleadings against any of the Released Parties with any governmental agency or in any court, based upon, arising out of or related in any way to any event or events occurring prior to the signing of this General Release, including, without limitation, his/her employment with any of the Released Parties or the termination thereof.

Employee acknowledges, understands and affirms that: (a) This General Release is a binding legal document; (b) Released Parties advised him/her to consult with an attorney before signing this General Release, (ii) he/she had the right to consult with an attorney about and before signing this General Release, (iii) he/she was given a period of at least 21 calendar days in which to consider this General Release prior to signing, and (iv) he/she voluntarily signs and enters into this General Release without reservation after having given the matter full and careful consideration; and (c) (i) Employee has a period of seven days after signing this General Release in which he/she may revoke this General Release, (ii) this General Release does not become effective or enforceable and no payment shall be made hereunder until this seven–day–revocation period has elapsed, and (iii) any revocation must be in writing by Employee and delivered to (specify), Human Resources within the seven–day–revocation period.

IN WITNESS WHEREOF, the Employee signs this General Release this ____ day of 2XXX.

_____________________
Employee's Name (please print)

_____________________
Witness

_____________________
Signature

_____________________
Date:

A C K N O W L E D G M E N T

I HEREBY ACKNOWLEDGE that [Name of Employer] in accordance with the Age Discrimination in Employment Act, as amended by the Older Workers Benefit Protection Act, informed me in writing: 1) to consult with an attorney before signing this General Release; 2) to review this General Release for a period of 21 days prior to signing; 3) that for a period of seven days following the signing of this General Release, I may revoke this General Release, and this General Release, will not become effective or enforceable until the seven–day–revocation period has elapsed; and 4) that no payment shall be made until the seven–day–revocation period has elapsed.

I HEREBY FURTHER ACKNOWLEDGE receipt of this General Release for my review on the _____ day of 2XXX.

_____________________
Witness

_____________________
Employee (Print or Type Name)

_____________________
Signature of Employee