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Insert Date [Insert Employee Name ] [Insert Employee ...

1 of 5 CAUTION: This document is only a basic template of things to consider. It is not all encompassing. Attorneys must use discretion and independent judgment to ensure any work product is appropriately tailored to the unique facts and circumstances of their matter. In addition, attorneys must review relevant Federal and Local Rules, standing orders, and any other orders to ensure compliance. SAMPLE separation AGREEMENT AND RELEASE 40 AND OVER [LETTERHEAD] Insert Date [ Insert Employee Name ] [ Insert Employee Address] _____ Dear _____: As you know, your employment with _____ (the Company ) will be terminated as of [ Insert date].

the time of your separation date, for 6 months; (b) a pro-rata portion of your annual bonus target for the year in which your termination occurs, plus any earned but unpaid bonus amounts from prior periods; (c) fully-subsidized COBRA coverage for ___ months, which will be paid directly by the Company to the carrier once you elect COBRA

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