Personal Injury Settlement Release - New York

New York · Fillable PDF · Free

A release ends an injury claim in exchange for a settlement payment. Many insurers require the claimant’s signature to be notarized before they issue the check. Document a release of injury claims in exchange for settlement payment.

Serving New York. New York appointments require New York-commissioned notaries.

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Who this form is for

Document a release of injury claims in exchange for settlement payment.
A release ends an injury claim in exchange for a settlement payment. Many insurers require the claimant’s signature to be notarized before they issue the check.

What you'll need

Read this packet's instructions and confirm the recipient's required form.
Gather the names, dates and supporting records requested in the PDF.
Bring acceptable identification for any required notarial act.

How to complete it

Read it carefully A release is final. Once signed, the claim usually cannot be reopened. Talk to an attorney before signing if you have any questions.
Sign before a notary Bring a current, government-issued photo ID.
Return the signed release as the insurer directs, and keep a copy.

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These forms are a free convenience, not legal advice. First Choice Mobile Notary & Apostille is not a law firm. Consult an attorney licensed in the relevant state for legal questions.

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