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(Hereinafter referred to as "Releasor"), hereby release of , , , (Hereinafter referred to as "Releasee"), and hereby remise, aquit, satisfy, and forever discharge the said Releasee from any and all claims, demands, manner or causes of action, suits, debts, convenants, contracts, controversies, agreements, liability, known or unknown, which said Releasor ever had, now has, or which any personal representative, successor, heir or assign of said Releasor, hereafter can, shall or may have, against said Releasee, by reason of any matter, cause or thing whatsoever, from the beginning of time to the date of this instrument.

Date: ___________________________

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