SAMPLE SETTLEMENT AGREEMENT

1. In exchange for the promises made by the BLANK (Agency), in paragraph 2 of this agreement, and in full and complete resolution of matters raised in his Equal Employment Opportunity

Commission (EEOC) complaint, BLANK, Complainant and the Agency, agree to the following conditions:

BLANK agrees to withdraw his formal discrimination case, EEOC Docket Number

#X, Agency Docket Number #Y, waives and releases the government, the Agency, its officers, managers, supervisors, and employees, in both their official and individual capacities, from any and all liability, claims, causes of action, etc., resulting from or relating to, in any manner, the subject matter of this settlement, and his employment with the Agency. This agreement constitutes a complete accord and satisfaction of any and all claims, including any and all

equitable and legal relief, e.g., attorney fees and costs, compensatory and consequential damages, etc.

This agreement resolves all disputes, all issues, and all disagreements between BLANK and the Agency arising out of or connected with the facts upon which the complaint was based.

Complainant agrees not to institute any such complaint, grievance, appeal, claim or lawsuit arising out of or in connection with the complaint, against the Agency, any of the Agency's employees or former employees, under the Civil Rights Act of 1964, Title VII, as amended, 42 U.S.C. Sec. 2 et seq., the Handicap Discrimination Act, 29 U.S.C. Sec. 791, et seq., the Civil Rights Act of 1866 and 1871, 42 U.S.C. §§ 1981, 1983, and 1985, the United States Constitution, or any other state, local or federal law relating to the above-captioned matter.

2. In exchange for the promises specified in paragraph 1, the Agency agrees:

a. To pay BLANK the lump sum of BLANK thousand ($X) dollars by Electronic Fund Transfer (EFT) within twenty (20) business days of the approval date of this agreement.

BLANK agrees to provide banking information no later than five days from the date he signs this agreement in order to complete the EFT. BLANK will provide the banking information to the Agency through its representative, Ms. Blank. No representations are made by the Agency as to the tax consequences of this payment.

b. The Agency agrees to restore to BLANK the total sum of # hours of leave. He will have # hours restored in Annual Leave and # hours restored in Sick Leave. The Agency will initiate the restoration of leave by submitting the required documentation to Ms. BLANK within twenty (20) business days of the approval date of this agreement. The Agency cannot make any

representations as to when the leave will be restored, since it lacks any control over Ms.

BLANK.

c. The Agency will pay attorney fees to NAME in the amount of $X by Electronic Fund Transfer (EFT) within twenty (20) business days of the approval date of this agreement.

BLANK has provided the banking information to the Agency’s representative in order to complete the EFT.

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3. BLANK also agrees not to institute a lawsuit under the Civil Rights Acts of 1964, Title VII, as amended, which prohibits discrimination in employment based on race, color, national origin, religion or sex, or under the Age Discrimination in Employment Act of 1967 (ADEA), which prohibits age discrimination in employment, or under the United States Constitution, or any other state or federal law prohibiting employment discrimination on any issues arising prior to the agreement or arising out of the subject matter of this settlement.

4. This agreement does not constitute an admission of guilt, fault, or wrongdoing by either party.

The settlement agreement will be entered into the record of the Equal Employment Opportunity Commission so that it will retain jurisdiction as to its case for purposes of enforcing compliance with the terms of this agreement. This agreement may be used as evidence in a later proceeding in which either of the parties alleges a breach of the agreement.

5. Other than the fees specified in paragraph 2b, the parties agree to bear their own costs related to all proceedings to date.

6. (Optional) This agreement will be kept confidential with only the parties having immediate knowledge of this case or parties having a need to know, in order to effectuate any of the terms of this agreement. BLANK understands that if he divulges the terms of this agreement to anyone (specifically any employee of the Agency) other than his immediate family members, the

Agency will rescind the actions agreed upon in paragraph 2 and recoup any funds tendered pursuant to that provision, without reinstatement of the complaint.

8. This agreement is entered into based on the authority provided by Section 717 of the Civil Rights Act of 1964, as amended (42 U.S.C. § 2000e-16); the Civil Rights Act of

1991; and 29 C.F.R. Subpart 1614.603 and the Alternative Dispute Resolution Act of 1996.

9. This agreement constitutes the complete understanding between BLANK and the Agency.

10. In accordance with 29 C.F.R. Section 1614.504, the parties further agree that, if

BLANK believes that the provisions of this negotiated settlement agreement are being violated, he must notify, in writing Mr. BLANK located at Address X within 30 calendar days of

becoming aware of the noncompliance. BLANK must exhaust the administrative process under 29 CFR § 1614.504.

11. By signing below, BLANK acknowledges reading this Agreement in its entirety, understanding all terms and conditions of this Agreement, and having done so, knowingly, voluntarily, and freely enters into this Agreement without coercion or duress.

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12. The Parties agree and understand that this Agreement, the effective date is noted below, does not become final and binding upon either party unless and until all coordination has been

completed and the Agreement is signed by the Agency Settlement Authority. To that end, the coordination sheet shall become a part of this Agreement.

______________________________ __________________

Complainant Date

______________________________ ____________________

Complainant’s Counsel/Represenative Date

_______________________________ __________________

Agency Representative Date

______________________________

Effective Date

U.S. Equal Employment Opportunity Commission

This is a sample Settlement Agreement from the U.S. Equal Employment Opportunity Commission

Available at: http://www.eeoc.gov/federal/adr/fsms-settlement.cfm