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Release By Creditor

Free Printable Release By Creditor FormFree Printable Release By Creditor Form

This review list is being supplied to you in order to inform you about the document in question and to aid you in preparing it for submission. Before making a final payment to a creditor, you must first get this Agreement, which must be signed by the creditor in issue and attested by a third party. Include this form as part of your settlement request as a proactive measure. It is important to note that you are not required to sign the Agreement and should not do so unless they specifically request that you do so as a countersignature. Sign this only after they have completed the task or at the same time as the meeting.


  1. Make many copies for each of the parties. Keep a copy in your home safe (if you haven’t obtained one yet, consider this another reminder to do so) and an original in your financial records.


  1. Share a copy of this agreement with prospective creditors to demonstrate that settlements can be successful and that they can be handled efficiently. This puts them on notice of your knowledge and experience in the area, as well as providing a strategy for resolving the issue that has been effectively implemented in other situations.


  1. This form should be used whenever you are compromising a claim with a creditor. It withstands the test of time and eliminates the prospect of a future dispute, which is especially important if the creditor is sold, combined, or otherwise restructured.

Release by Creditor


To: _______________, Being Released from Obligation (the “Releasee”)

Settlement Amount $______________ Amount of Payment to Creditor (“Settlement Amount”)

From: _______________ (“Releasor”)

In consideration of the payment of the above Settlement Amount by Releasee to Releasor and for other good and valuable consideration, the receipt and sufficiency of which is acknowledged, the Releasor hereby agrees as follows:
1. That the Settlement Amount represents payment in full satisfaction of all indebtedness, liabilities and obligations of the Releasee to the Releasor; and

2. That the Releasor hereby releases and forever discharges the Releasee and its, employees, officers, directors, successors and assigns of and from all actions, causes of action, damages, claims and demands whatsoever, which the Releasor had, now has or which the Releasor hereafter can, shall or may have for any reason whatsoever, including but not limited to all actions, causes of action, damages, claims and demands arising out of any indebtedness, liabilities or obligations owing by the Releasee to the Releasor.

3. This Release shall inure to the benefit of the Releasee and its employees, officers, directors, successors and assigns, and shall be binding upon the Releasor and its heirs, executors, administrators, successors and assigns.


__________________ Date:
Creditor, by Authorized Signer


Release by Creditor
Review List

This review list is provided to inform you about this document in question and assist you in its preparation. This is the Agreement you must receive, signed by the Creditor in question and witnessed thereto, before tendering final payment to them. When requesting settlement, include this form as a proactive step. Note that you do not need to sign the Agreement nor should unless requested by them for you to make a counter signature. Only sign this after they have done so or at the same time of a meeting.

1. Make multiple copies for the parties. Keep an original in your home safe (if you haven’t gotten one yet, consider this another prompting to do so) and copies in your financial files.

2. Use a copy of this agreement with future creditors to show that settlements can work and be implemented effectively. This puts them on notice as to your expertise and experience in the matter, as well as outlining an approach to resolution successfully accomplished in the past.

3. Use this form when ever compromising a claim with a creditor. It stands up well over time and prevents the possibility of any future dispute, especially if the creditor is sold, merged, or otherwise reorganized.

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