Sample Waiver Letter For Claims

October 10, 2050

Charles Nash
SquareHold Financial Inc.

Kanawha, IA 50447

Dear Mr. Nash,

I, Janice Herbolt, am writing this letter to formally waive any and all claims, rights, or causes of action that I may have against Squarehold Insurance Company related to the auto accident that occurred on October 5, 2050, at the intersection of Oak Street and Maple Avenue. I was involved in this accident, and the claim number associated with this incident is 226535.

I understand that by signing this waiver, I am releasing Squarehold Insurance Company, its officers, employees, agents, and representatives from any liability, responsibility, or obligation arising from the aforementioned auto accident.

I acknowledge that I have had the opportunity to seek legal counsel and have been advised of my rights and the potential consequences of waiving those rights. I am making this decision willingly and with a full understanding of its implications.

I further confirm that I have received the agreed-upon settlement amount of $5,000 in exchange for waiving these claims, which will cover medical expenses, property damage, and any other related costs.

This waiver is effective as of the date of this letter and is a complete and final release of all claims related to the specified auto accident on October 5, 2050.

If required, I am enclosing a copy of the police report, medical bills, and any other relevant documentation necessary to formalize this waiver.

Please provide a copy of this waiver, duly signed and dated by an authorized representative of Squarehold Insurance Company, as evidence of the acknowledgment and acceptance of this waiver.

Thank you for your prompt attention to this matter.

Yours sincerely,
Janice Herbolt