407.4E3 - Licensed Employee Early Separation Program

A copy of the agreement/waiver and release was given to

                                                                 on the                     day of

,20                 and the 45 days in which to consider the Agreement expires on the

               day of                                       , 20                .    The above-named employee was

given the full 45 days but voluntarily chose to sign the Agreement before that date. By his/her signature, the employee acknowledges that he/she could have taken the full 45 days, but voluntarily decided to sign the Agreement before that date.

 

 

Signature Date

 

Witness