GENERAL RELEASE _____________, 20__ In consideration of _____________________________ ________________________________________________________ to _______________ paid by ___________________ the receipt whereof is hereby acknowledged _______ hereby remise, release and forever discharge the said ___________________ of and from all debts, demands, actions, causes of action, suits, accounts, covenants, contracts, agreements, damages, and any and all claims, demands and liabilities whatsoever of every name and nature, both in law and in equity, which against the said ________________ or _______________ heirs and assigns __________________ now have or ever had from the beginning of the world to this date and more especially on account of __________________________________________________. Witness ____________ hand and seal _______________________ Signed in the presence of ___________________________________ _______________________ Form 614