RELEASE OF CLAIMS



In consideration of the sum of [amount]           Dollars,

($      ), the receipt of which is hereby acknowledged,

[name of creditor] of   [address]   , City of             ,

County of             , State of              , does hereby

release and discharge the estate, administrator, executor

and heirs of the decedent from any and claims that [name of

creditor] has or may have in the future against the estate

of [name of deceased], deceased.



Dated: _____________                  _____________________

                                           [Signature]

[Acknowledgement]





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