Free Car Accident Release Form Template

Car Accident Release Form

Please fill out this form completely to acknowledge and release claims related to the car accident.

Releasor Information

Name

    Phone Number

      Email

        Incident Details

        Date of Accident

          Location Address of Accident

            Description of Incident

              Vehicle Information

              Make/Model

                License Plate Number

                  Releasee Information

                  Name

                    Phone Number

                      Email

                        Acknowledgment and Release

                        • I, the undersigned (Releasor), acknowledge receipt of compensation or other resolution for damages or injuries related to the car accident described above.

                        • I release and discharge [Your Company Name], its employees, agents, or involved parties (Releasee) from any further claims, demands, or liabilities arising from the incident, except in cases of gross negligence or fraud.

                        • I confirm that this release is granted voluntarily and with a full understanding of its terms.

                        Do you consent to the release as described in this form?

                        I hereby confirm that all the above information is true and authentic and that I have read, understood, and agree to the terms and conditions.

                        Your Name

                        Date Signed

                        Release Form Templates @ Template.net