Maryland Personal Injury Demand Letter

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PERSONAL INJURY DEMAND LETTER

STATE OF MARYLAND


CONFIDENTIAL SETTLEMENT COMMUNICATION

Subject to Maryland Rule 5-408 and Federal Rule of Evidence 408

SENDER INFORMATION

Law Firm/Attorney: [________________________________]

Bar Number: [________________________________]

Address: [________________________________]

City, State, ZIP: [________________________________]

Telephone: [________________________________]

Facsimile: [________________________________]

Email: [________________________________]


RECIPIENT INFORMATION

Date: [__/__/____]

Insurance Company: [________________________________]

Claims Department Address: [________________________________]

City, State, ZIP: [________________________________]

Adjuster Name: [________________________________]

Claim Number: [________________________________]

Policy Number: [________________________________]

Insured Name: [________________________________]

Date of Loss: [__/__/____]


RE: DEMAND FOR SETTLEMENT

Claimant: [________________________________]

Date of Birth: [__/__/____]

Date of Incident: [__/__/____]

Location of Incident: [________________________________]

Type of Claim: ☐ Motor Vehicle Accident ☐ Premises Liability ☐ Product Liability ☐ Medical Malpractice ☐ Other: [________________________________]


I. INTRODUCTION AND PURPOSE

This letter constitutes a formal demand for settlement on behalf of [________________________________] ("Claimant") for personal injuries, economic losses, and non-economic damages sustained as a direct and proximate result of the negligence of your insured, [________________________________], on [__/__/____].

This demand is made pursuant to the laws of the State of Maryland and is intended to provide you with sufficient information to evaluate this claim and make a good faith settlement offer in accordance with Maryland's Unfair Claims Settlement Practices Act, Md. Code, Ins. § 27-1001 et seq.

NOTICE: Pursuant to Maryland law, your company is required to acknowledge receipt of this claim within 15 working days and must complete its investigation within 45 days or provide written notice explaining the reason for delay. Failure to act in good faith may subject your company to liability under Md. Code, Ins. § 27-1001.


II. STATEMENT OF FACTS

A. Pre-Incident Background

Prior to the incident, Claimant was a [____]-year-old [________________________________] (occupation) in good health with no significant prior injuries to the affected body parts. Claimant's pre-incident physical condition can be described as follows:

[________________________________]
[________________________________]
[________________________________]

B. Detailed Description of the Incident

Date: [__/__/____]

Time: [____:____] ☐ AM ☐ PM

Location: [________________________________]

County: [________________________________], Maryland

Weather Conditions: [________________________________]

Road/Surface Conditions: [________________________________]

Narrative of Events:

[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]

C. Emergency Response

911 Called: ☐ Yes ☐ No

Time of Call: [____:____] ☐ AM ☐ PM

Responding Agency: [________________________________]

Report Number: [________________________________]

Emergency Medical Services: ☐ Yes ☐ No

EMS Provider: [________________________________]

Transport Destination: [________________________________]

D. Witnesses

# Name Contact Information Relationship Summary of Observations
1 [________________________________] [________________________________] [________________________________] [________________________________]
2 [________________________________] [________________________________] [________________________________] [________________________________]
3 [________________________________] [________________________________] [________________________________] [________________________________]

III. LIABILITY ANALYSIS

A. Negligence of Your Insured

Your insured, [________________________________], was negligent in the following respects:

☐ Failed to maintain a proper lookout
☐ Failed to yield the right of way
☐ Operated a vehicle at an excessive rate of speed
☐ Violated Maryland Transportation Article § [________________________________]
☐ Failed to maintain premises in a reasonably safe condition
☐ Failed to warn of known dangerous conditions
☐ Violated applicable building codes or safety regulations
☐ Other: [________________________________]

Specific Acts of Negligence:
  1. [________________________________]
  2. [________________________________]
  3. [________________________________]
  4. [________________________________]

B. Maryland Contributory Negligence Doctrine

CRITICAL MARYLAND LAW CONSIDERATION:

Maryland is one of only five jurisdictions in the United States that continues to follow the doctrine of pure contributory negligence. Under this doctrine, if a plaintiff is found to have contributed in any degree—even 1%—to the accident that caused their injuries, they are completely barred from recovery. Coleman v. Soccer Ass'n of Columbia, 432 Md. 679 (2013); Harrison v. Montgomery County Bd. of Educ., 295 Md. 442 (1983).

Claimant's Freedom from Contributory Negligence:

Our investigation has thoroughly established that Claimant bears absolutely no fault for this incident. The following evidence conclusively demonstrates Claimant's complete freedom from contributory negligence:

  1. [________________________________]
  2. [________________________________]
  3. [________________________________]
  4. [________________________________]

Supporting Evidence:

☐ Police report confirms your insured was solely at fault
☐ Traffic citation issued to your insured for: [________________________________]
☐ Witness statements confirm Claimant's proper conduct
☐ Video/photographic evidence establishes Claimant's actions were reasonable
☐ Expert analysis confirms Claimant could not have avoided the incident
☐ Other: [________________________________]

C. Last Clear Chance Doctrine

Even if your insured attempts to assert contributory negligence (which is not supported by the evidence), Maryland recognizes the "last clear chance" doctrine. Under this doctrine, a plaintiff may recover despite their own negligence if the defendant had the last clear opportunity to avoid the accident and failed to do so. Pahanish v. Western Trails, Inc., 69 Md. App. 342 (1986).

In this case, your insured had the last clear chance to avoid this incident because:

[________________________________]
[________________________________]
[________________________________]


IV. DETAILED DESCRIPTION OF INJURIES

A. Initial Injuries Sustained

Immediately following the incident, Claimant sustained the following injuries:

Primary Injuries:

  1. [________________________________]
  2. [________________________________]
  3. [________________________________]
  4. [________________________________]

Secondary/Associated Injuries:

  1. [________________________________]
  2. [________________________________]
  3. [________________________________]

B. Diagnosis Codes (ICD-10)

Code Description
[________________________________] [________________________________]
[________________________________] [________________________________]
[________________________________] [________________________________]
[________________________________] [________________________________]
[________________________________] [________________________________]

C. Detailed Injury Narrative

[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]

D. Permanent Conditions/Residual Effects

As a result of the injuries sustained, Claimant has been left with the following permanent conditions:

☐ Chronic pain in [________________________________]
☐ Limited range of motion in [________________________________]
☐ Scarring/disfigurement to [________________________________]
☐ Nerve damage affecting [________________________________]
☐ Cognitive impairment including [________________________________]
☐ Post-traumatic stress affecting [________________________________]
☐ Other permanent conditions: [________________________________]


V. MEDICAL TREATMENT HISTORY

A. List of Medical Providers

# Provider Name Specialty Address Phone Dates of Treatment
1 [________________________________] [________________________________] [________________________________] [________________________________] [__/__/____] to [__/__/____]
2 [________________________________] [________________________________] [________________________________] [________________________________] [__/__/____] to [__/__/____]
3 [________________________________] [________________________________] [________________________________] [________________________________] [__/__/____] to [__/__/____]
4 [________________________________] [________________________________] [________________________________] [________________________________] [__/__/____] to [__/__/____]
5 [________________________________] [________________________________] [________________________________] [________________________________] [__/__/____] to [__/__/____]
6 [________________________________] [________________________________] [________________________________] [________________________________] [__/__/____] to [__/__/____]
7 [________________________________] [________________________________] [________________________________] [________________________________] [__/__/____] to [__/__/____]
8 [________________________________] [________________________________] [________________________________] [________________________________] [__/__/____] to [__/__/____]

B. Treatment Timeline

Emergency/Acute Phase ([__/__/____] - [__/__/____])

Date: [__/__/____]
Provider: [________________________________]
Type of Visit: ☐ Emergency Room ☐ Urgent Care ☐ Ambulance Transport
Treatment Rendered: [________________________________]
Findings: [________________________________]
Recommendations: [________________________________]

Date: [__/__/____]
Provider: [________________________________]
Type of Visit: [________________________________]
Treatment Rendered: [________________________________]
Findings: [________________________________]
Recommendations: [________________________________]

Active Treatment Phase ([__/__/____] - [__/__/____])

Primary Care/Specialist Visits:

Date Provider Treatment Notes
[__/__/____] [________________________________] [________________________________] [________________________________]
[__/__/____] [________________________________] [________________________________] [________________________________]
[__/__/____] [________________________________] [________________________________] [________________________________]
[__/__/____] [________________________________] [________________________________] [________________________________]
[__/__/____] [________________________________] [________________________________] [________________________________]

Physical Therapy/Rehabilitation:

Date Range Provider # Sessions Treatment Focus
[__/__/____] to [__/__/____] [________________________________] [____] [________________________________]
[__/__/____] to [__/__/____] [________________________________] [____] [________________________________]
[__/__/____] to [__/__/____] [________________________________] [____] [________________________________]

Diagnostic Imaging/Testing:

Date Facility Type of Test Findings
[__/__/____] [________________________________] ☐ X-Ray ☐ MRI ☐ CT ☐ EMG ☐ Other: [____] [________________________________]
[__/__/____] [________________________________] ☐ X-Ray ☐ MRI ☐ CT ☐ EMG ☐ Other: [____] [________________________________]
[__/__/____] [________________________________] ☐ X-Ray ☐ MRI ☐ CT ☐ EMG ☐ Other: [____] [________________________________]

Surgical Procedures (if applicable):

Date Facility Surgeon Procedure CPT Code
[__/__/____] [________________________________] [________________________________] [________________________________] [________________________________]
[__/__/____] [________________________________] [________________________________] [________________________________] [________________________________]
Maintenance/Ongoing Phase ([__/__/____] - Present)

Current Treatment Status:

☐ Treatment completed; discharged to self-care
☐ Treatment completed with permanent restrictions
☐ Ongoing maintenance care required
☐ Additional treatment recommended: [________________________________]

Prognosis:

[________________________________]
[________________________________]
[________________________________]


VI. MEDICAL EXPENSE BREAKDOWN

A. Itemized Medical Expenses

Provider Service Description Date(s) Billed Amount Paid/Adjusted Balance Due
[________________________________] [________________________________] [__/__/____] $[________] $[________] $[________]
[________________________________] [________________________________] [__/__/____] $[________] $[________] $[________]
[________________________________] [________________________________] [__/__/____] $[________] $[________] $[________]
[________________________________] [________________________________] [__/__/____] $[________] $[________] $[________]
[________________________________] [________________________________] [__/__/____] $[________] $[________] $[________]
[________________________________] [________________________________] [__/__/____] $[________] $[________] $[________]
[________________________________] [________________________________] [__/__/____] $[________] $[________] $[________]
[________________________________] [________________________________] [__/__/____] $[________] $[________] $[________]
[________________________________] [________________________________] [__/__/____] $[________] $[________] $[________]
[________________________________] [________________________________] [__/__/____] $[________] $[________] $[________]

B. Summary of Medical Expenses by Category

Category Total Amount
Emergency Room/Hospital $[________]
Ambulance/Transport $[________]
Primary Care Physician $[________]
Specialist Consultations $[________]
Physical Therapy $[________]
Chiropractic Care $[________]
Diagnostic Imaging (X-Ray, MRI, CT) $[________]
Laboratory/Pathology $[________]
Surgical Procedures $[________]
Prescription Medications $[________]
Durable Medical Equipment $[________]
Mental Health Treatment $[________]
Other Medical Expenses $[________]
TOTAL PAST MEDICAL EXPENSES $[________]

C. Health Insurance/Subrogation Information

Health Insurance Carrier: [________________________________]

Policy Number: [________________________________]

Amount Paid by Health Insurance: $[________]

Subrogation/Lien Amount: $[________]

Medicare/Medicaid Involvement: ☐ Yes ☐ No

If Yes, Conditional Payment Amount: $[________]


VII. LOST WAGES AND LOSS OF EARNING CAPACITY

A. Employment Information

Employer: [________________________________]

Position/Title: [________________________________]

Employment Start Date: [__/__/____]

Employment Status at Time of Incident: ☐ Full-Time ☐ Part-Time ☐ Self-Employed

Work Schedule: [____] hours per week

B. Income Documentation

Hourly Rate: $[________] OR Annual Salary: $[________]

Average Weekly Gross Income: $[________]

Average Weekly Net Income: $[________]

Additional Compensation (bonuses, commissions, overtime): $[________]

C. Lost Time Calculation

Period Dates Type of Loss Days/Hours Lost Amount
Initial Absence [__/__/____] to [__/__/____] ☐ Total ☐ Partial [____] days $[________]
Follow-up Appointments Various Medical visits [____] hours $[________]
Reduced Hours/Light Duty [__/__/____] to [__/__/____] Partial wages [____] hours $[________]
Ongoing Treatment [__/__/____] to [__/__/____] Medical visits [____] hours $[________]

TOTAL PAST LOST WAGES: $[________]

D. Verification

☐ Employer verification letter attached
☐ Pay stubs for 6 months prior to incident attached
☐ Tax returns for [____] year(s) attached
☐ Self-employment income documentation attached

E. Loss of Earning Capacity (if applicable)

Pre-Incident Earning Capacity: $[________] per year

Post-Incident Earning Capacity: $[________] per year

Annual Reduction: $[________]

Work Life Expectancy: [____] years

Present Value Calculation: $[________]

Basis for Calculation:

[________________________________]
[________________________________]
[________________________________]


VIII. PAIN AND SUFFERING NARRATIVE

A. Physical Pain and Discomfort

The injuries sustained by Claimant have caused and continue to cause significant physical pain and suffering. In Claimant's own words:

[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]

Pain Level Assessment:

  • Initial pain level (0-10 scale): [____]
  • Peak pain level during treatment: [____]
  • Current pain level: [____]
  • Activities that aggravate pain: [________________________________]

B. Emotional and Psychological Impact

The incident and resulting injuries have had a profound emotional and psychological impact on Claimant:

☐ Anxiety, particularly related to [________________________________]
☐ Depression symptoms including [________________________________]
☐ Post-traumatic stress symptoms including [________________________________]
☐ Sleep disturbances including [________________________________]
☐ Fear of [________________________________]
☐ Mood changes affecting [________________________________]
☐ Other psychological effects: [________________________________]

Narrative:

[________________________________]
[________________________________]
[________________________________]
[________________________________]

C. Impact on Daily Living Activities

The injuries have significantly impacted Claimant's ability to perform normal daily activities:

Activity Pre-Incident Ability Post-Incident Ability Duration of Limitation
Personal hygiene/grooming [________________________________] [________________________________] [________________________________]
Household chores [________________________________] [________________________________] [________________________________]
Cooking/meal preparation [________________________________] [________________________________] [________________________________]
Driving [________________________________] [________________________________] [________________________________]
Shopping/errands [________________________________] [________________________________] [________________________________]
Childcare responsibilities [________________________________] [________________________________] [________________________________]
Sleep quality [________________________________] [________________________________] [________________________________]

D. Impact on Recreational Activities and Hobbies

Prior to this incident, Claimant regularly engaged in the following activities that have been curtailed or eliminated:

Activity Frequency Before Current Status Permanent Limitation
[________________________________] [________________________________] [________________________________] ☐ Yes ☐ No
[________________________________] [________________________________] [________________________________] ☐ Yes ☐ No
[________________________________] [________________________________] [________________________________] ☐ Yes ☐ No
[________________________________] [________________________________] [________________________________] ☐ Yes ☐ No

E. Impact on Family and Social Relationships

[________________________________]
[________________________________]
[________________________________]
[________________________________]

F. Loss of Consortium (if applicable)

Spouse Name: [________________________________]

The injuries have adversely affected the marital relationship in the following ways:

[________________________________]
[________________________________]
[________________________________]


IX. PROPERTY DAMAGE

A. Vehicle Damage (if applicable)

Year/Make/Model: [________________________________]

VIN: [________________________________]

Fair Market Value (Pre-Incident): $[________]

Damage Assessment:

☐ Repairable – Estimated Repair Cost: $[________]
☐ Total Loss – Actual Cash Value: $[________]

Body Shop/Appraiser: [________________________________]

Estimate Number: [________________________________]

B. Other Property Damage

Item Description Value
[________________________________] [________________________________] $[________]
[________________________________] [________________________________] $[________]
[________________________________] [________________________________] $[________]

C. Loss of Use

Rental Vehicle Cost: $[________] for [____] days

Other Transportation Expenses: $[________]

TOTAL PROPERTY DAMAGE: $[________]


X. FUTURE MEDICAL CARE AND EXPENSES

A. Recommended Future Treatment

Based on the opinions of Claimant's treating physicians, the following future medical care is reasonably anticipated:

Treatment Provider/Facility Frequency Duration Estimated Cost
[________________________________] [________________________________] [________________________________] [________________________________] $[________]
[________________________________] [________________________________] [________________________________] [________________________________] $[________]
[________________________________] [________________________________] [________________________________] [________________________________] $[________]
[________________________________] [________________________________] [________________________________] [________________________________] $[________]
[________________________________] [________________________________] [________________________________] [________________________________] $[________]

B. Future Surgical Procedures (if anticipated)

Procedure Surgeon Estimated Timing Estimated Cost
[________________________________] [________________________________] [________________________________] $[________]
[________________________________] [________________________________] [________________________________] $[________]

C. Life Care Plan Summary (if applicable)

A life care plan has been prepared by [________________________________], which projects lifetime medical costs of $[________]. Key components include:

[________________________________]
[________________________________]
[________________________________]

D. Future Medical Expense Summary

Category Estimated Cost
Future Medical Treatment $[________]
Future Surgical Procedures $[________]
Future Physical Therapy $[________]
Future Medications $[________]
Future Durable Medical Equipment $[________]
Home Modifications (if needed) $[________]
TOTAL ESTIMATED FUTURE MEDICAL $[________]

XI. MARYLAND-SPECIFIC DAMAGES CONSIDERATIONS

A. Non-Economic Damages Cap

Pursuant to Md. Code, Cts. & Jud. Proc. § 11-108, Maryland imposes a statutory cap on non-economic damages in personal injury actions. The cap increases by $15,000 each year on October 1st.

Current Cap (as of October 1, 2025): $965,000 for a single plaintiff

Cap for Wrongful Death with Multiple Beneficiaries: $1,447,500 (150% of single plaintiff cap)

Note: The applicable cap is determined by the date the cause of action accrues, not the date of judgment.

Date of Incident: [__/__/____]

Applicable Non-Economic Damages Cap: $[________]

B. Joint and Several Liability

Maryland follows the common law doctrine of joint and several liability. Each defendant whose negligent act proximately causes injury may be held liable for the entire amount of damages, regardless of their individual percentage of fault.

C. Collateral Source Rule

Maryland follows the collateral source rule, which provides that a defendant tortfeasor may not benefit from collateral payments made to the plaintiff from sources such as health insurance. The full reasonable value of medical services may be claimed regardless of amounts actually paid.


XII. SUMMARY OF DAMAGES

A. Economic Damages (Special Damages)

Category Amount
Past Medical Expenses $[________]
Future Medical Expenses $[________]
Past Lost Wages $[________]
Future Lost Wages/Earning Capacity $[________]
Property Damage $[________]
Out-of-Pocket Expenses $[________]
TOTAL ECONOMIC DAMAGES $[________]

B. Non-Economic Damages (General Damages)

Category Amount
Physical Pain and Suffering $[________]
Mental Anguish and Emotional Distress $[________]
Loss of Enjoyment of Life $[________]
Inconvenience $[________]
Physical Impairment/Disability $[________]
Disfigurement/Scarring $[________]
Loss of Consortium (if applicable) $[________]
TOTAL NON-ECONOMIC DAMAGES $[________]

Note: Non-economic damages are subject to the statutory cap under Md. Code, Cts. & Jud. Proc. § 11-108.

C. Total Demand

Category Amount
Total Economic Damages $[________]
Total Non-Economic Damages $[________]
TOTAL DAMAGES $[________]

XIII. SETTLEMENT DEMAND

Based upon the foregoing, we hereby demand payment in the amount of:

$[________________________________]

to fully and finally settle all claims arising from this incident.

This demand represents fair compensation for Claimant's injuries, economic losses, and non-economic damages, and takes into account:

☐ The clear liability of your insured
☐ Claimant's complete freedom from contributory negligence
☐ The severity and permanence of Claimant's injuries
☐ The substantial economic losses incurred
☐ The significant impact on Claimant's quality of life
☐ The applicable statutory cap on non-economic damages
☐ Potential verdict exposure at trial


XIV. RESPONSE DEADLINE AND CONSEQUENCES

A. Response Required

Please provide a written response to this demand within thirty (30) days of your receipt of this letter, no later than [__/__/____].

B. Good Faith Settlement Obligations

We remind you of your obligations under Maryland's Unfair Claims Settlement Practices Act, Md. Code, Ins. § 27-1001 et seq., which requires insurers to:

  • Acknowledge communications within 15 working days
  • Complete claim investigations within 45 days or provide written explanation
  • Attempt in good faith to effectuate prompt, fair settlements
  • Provide reasonable explanations for claim denials

C. Statute of Limitations Notice

The applicable statute of limitations under Md. Code, Cts. & Jud. Proc. § 5-101 is three (3) years from the date of incident.

Date of Incident: [__/__/____]

Statute of Limitations Expiration: [__/__/____]

We reserve all rights to file suit prior to the expiration of the statute of limitations if a fair settlement cannot be reached.

D. Preservation of Evidence

This letter serves as formal notice to preserve all evidence related to this incident, including but not limited to:

  • All documents, photographs, and video recordings
  • All communications related to this claim
  • All claim notes and investigation materials
  • Vehicle(s) involved in the incident
  • Electronic data and metadata

Spoliation of evidence may result in adverse inference instructions at trial.


XV. DOCUMENTATION CHECKLIST

The following documents are enclosed with this demand:

Medical Records and Bills

☐ Emergency room records and bills
☐ Hospital admission/discharge records
☐ Primary care physician records
☐ Specialist consultation records
☐ Physical therapy records
☐ Chiropractic treatment records
☐ Diagnostic imaging reports (X-ray, MRI, CT)
☐ Surgical operative reports
☐ Prescription records
☐ Itemized medical bills from all providers
☐ Explanation of Benefits (EOBs)
☐ Health insurance lien/subrogation letter

Liability Documentation

☐ Police/incident report
☐ Photographs of accident scene
☐ Photographs of vehicle damage
☐ Photographs of injuries
☐ Witness statements
☐ Traffic citation(s)
☐ Surveillance/dashcam footage
☐ Expert reports (accident reconstruction, etc.)

Employment and Income Documentation

☐ Employer verification letter
☐ Pay stubs (6 months prior to incident)
☐ Tax returns ([____] years)
☐ W-2 forms
☐ Documentation of lost benefits

Property Damage Documentation

☐ Vehicle repair estimate
☐ Total loss valuation
☐ Rental car receipts
☐ Photographs of damaged property
☐ Receipts for damaged personal property

Other Documentation

☐ Claimant's affidavit/declaration
☐ Day-in-the-life documentation
☐ Correspondence with your company
☐ Prior demand letters (if any)
☐ Life care plan (if applicable)
☐ Vocational expert report (if applicable)
☐ Economic loss report (if applicable)


XVI. CONCLUSION

The evidence clearly establishes that your insured was negligent and that Claimant was free from any contributory negligence. The injuries sustained are significant, well-documented, and have profoundly impacted Claimant's life. The damages sought are reasonable and supported by the evidence.

We trust that you will evaluate this claim in good faith and respond with a fair settlement offer within the time specified. We remain available to discuss this matter and to provide any additional information you may reasonably require.

If we do not receive an acceptable settlement offer, we are prepared to file suit and present this case to a Maryland jury.


Respectfully submitted,

Signature: [________________________________]

Printed Name: [________________________________]

Title: [________________________________]

Date: [__/__/____]


XVII. CLAIMANT AUTHORIZATION

I, [________________________________], hereby authorize my attorney to submit this demand on my behalf. I have reviewed the contents of this letter and confirm that the information provided is true and accurate to the best of my knowledge.

Claimant Signature: [________________________________]

Date: [__/__/____]


This demand letter is a confidential settlement communication and is inadmissible in evidence pursuant to Maryland Rule 5-408. This letter is not intended to be, and should not be construed as, a complete statement of all facts and claims. All rights are expressly reserved.

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About This Template

Personal injury cases are brought by people who were hurt because of someone else's carelessness: car crashes, slip and falls, defective products, and more. Demand letters, settlement agreements, and court filings in these cases have to document the injuries, the medical treatment, the lost income, and the exact legal basis for holding the other side responsible. Well-prepared paperwork is what drives higher settlements and forces insurers to take the claim seriously.

Important Notice

This template is provided for informational purposes. It is not legal advice. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.

Last updated: February 2026