A meeting was held on the day of , 20
with the following people present:
The following items were discussed: (Check if covered)
Benefits to be provided
Waiver and release terms
The employee has no obligation to accept early retirement
45 days to consider agreement/waiver and release ends as of
The employee's right to consult an attorney prior to signing or to answer questions
The employee has the right and ability to revoke signed agreement/waiver and release within 7
Days
A copy of the agreement/waiver and release and this document was given to the employee.
The signatures below only acknowledge that the items were covered and can not be used to prove assent to any terms of the agreement/waiver and release.
Signature Date
Signature Date
Signature Date
