Acknowledgment of Payment and Release

Free Acknowledgment of Payment and Release Template

Use this free template to confirm receipt of payment and release the paying party from related claims. Copy and customise it to suit your settlement and the underlying matter.

ACKNOWLEDGMENT OF PAYMENT AND RELEASE

Date: [Date]

Releasor (Recipient of payment): [Full legal name], of [Address] ("Releasor")

Releasee (Payer): [Full legal name], of [Address] ("Releasee")

Background

A. A dispute, debt, or obligation existed between the Parties relating to [brief description of the underlying matter, contract, invoice, or claim, with dates and reference numbers where relevant].

B. The Parties have agreed to settle the matter by payment from the Releasee to the Releasor of the sum set out below.

C. The Releasor wishes to acknowledge receipt of that payment and release the Releasee from further claims arising from the matter, on the terms set out in this Acknowledgment.

1. Acknowledgment of Payment

The Releasor acknowledges receipt from the Releasee of the sum of [Currency and amount in words] ([Currency and amount in numerals]) (the "Settlement Sum") on [Date of payment] by [Bank transfer / Cheque / Other], with reference [Payment reference, if any].

2. Full and Final Settlement

The Settlement Sum is accepted by the Releasor in full and final settlement of all and any claims, demands, actions, debts, sums of money, accounts, and causes of action that the Releasor has or may have against the Releasee arising out of or in connection with the matter described in the Background.

3. Release

The Releasor releases and forever discharges the Releasee, its directors, officers, employees, agents, and successors from all claims, liabilities, and obligations relating to or arising from the matter described in the Background, whether known or unknown, present or future, at law or in equity.

4. Exclusions (optional — include only if certain claims are not being released)

This release does not extend to:

• [Specific claim being preserved, e.g. ongoing service obligations under a separate contract]
• [Other excluded matters]

5. No Admission of Liability

This Acknowledgment is entered into without any admission of liability by either Party. The payment is made and accepted solely to resolve the matter and avoid further dispute.

6. Confidentiality

The Parties shall keep the terms of this Acknowledgment confidential and shall not disclose them to any third party, except: (a) to their professional advisors under a duty of confidence; (b) as required by law or by a court order; or (c) with the prior written consent of the other Party.

7. Entire Agreement

This Acknowledgment constitutes the entire agreement between the Parties in relation to the matter described in the Background and supersedes all prior negotiations, correspondence, and understandings.

8. Governing Law and Jurisdiction

This Acknowledgment is governed by the laws of [Jurisdiction] and the Parties submit to the exclusive jurisdiction of the courts of [Jurisdiction].

Signatures:

Releasor: _ Date: _

Name: _ Position: _

Releasee: _ Date: _

Name: _ Position: _

This is a basic template provided for informational purposes. For a professionally generated and legally tailored document, use Bind's contract automation platform.