Who is Employee?

• Indicate the Employee's full name (i.e. a person that is hired for work):

• Indicate the Employee's full residential address:

• Select the date on which the Employee’s employment commenced:

General Information

• Select the state whose laws govern the original employment contract between the Employee and the Employer:

  Choose option Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Illinois Indiana Idaho Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming District of Columbia

• Select the date on which this severance agreement becomes effective:

• Enter the date when the employment relationship is scheduled to end:

Financial Compensation

• Should the Employee receive a severance payment upon termination of employment?

  • Yes
  • No

  !

  Severance pay is a financial payment an employer gives an employee when their employment ends, typically to help support them during the transition after termination.

• Indicate the total amount of the severance payment, in U.S. dollars:

  !

  Neither federal nor state laws set a minimum or maximum amount for severance pay. Determining the severance amount is entirely at the employer’s discretion.

• How should the severance payment be made?

  • in full on the date of signing this agreement
  • in full on the other date
  • according to specific schedule

• Select the other date on which the severance payment should be paid in full:

• Describe in detail the schedule according to which the severance compensation will be paid:

• List all applicable payment methods Employer can use to make a severance payment:

• Should the severance package include reimbursement for unused paid vacation days?

  • No
  • Yes

• Specify the number of unused vacation days eligible for compensation:

• Specify the compensation amount for unused vacation days (in U.S. dollars):

Other Benefits

• Upon termination of employment, will the Employee retain access to certain Employer-sponsored benefit plans (e.g., insurance, COBRA)?

  • No
  • Yes

• List all benefits to which the Employee will retain access:

• Will the Employee receive any unpaid commissions and bonuses?

  • No
  • Yes

• Indicate the total amount of unpaid commissions and bonuses, in U.S. dollars:

• Will the Employee continue receiving contributions to their retirement accounts or pension plans?

  • No
  • Yes

• Specify the total contribution amount for retirement accounts and pension plans, in U.S. dollars:

• Will the Employee retain access to any additional benefits not listed above?

  • No
  • Yes

• List all the alternative benefits Employee shall retain access to:

Miscellaneous

• For how long after employment termination must the Employee maintain the confidentiality of information?

  Choose option one (1) year two (2) years three (3) years five (5) years

  !

  Confidential Information means information which is commercially valuable to Employer.

  Confidential Information includes documents, techniques, methods, practices, tools, specifications, inventions, patents, trademarks, copyrights, equipment, algorithms, models, samples, software, drawings, sketches, plans, programs or other oral or written knowledge and/or secrets etc.

• Shall the Employee refrain from engaging in any employment, consulting, or business activities that directly compete with the Employer’s interests?

  • No
  • Yes

  !

  The non-compete obligation prohibits the Employee from engaging in similar business ventures, working for competitors, consulting for competing entities, or participating in any activities that may be considered competitive or harmful to the Employer’s business interests.

  This clause is optional and may be included in the severance agreement at the parties’ discretion. It is typically applied to key employees, such as directors, the CEO, and other senior executives.

• Indicate how long the non-compete restriction will apply following the end of employment:

  Choose option one (1) year two (2) years three (3) years

• Specify the exact geographic area to which the non-compete obligation applies:

• Select the date on which both parties sign this agreement:

• Do you want to add Employer's signature?

  • Yes
  • No

• Employer's signature:

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