Case File
efta-efta00283046DOJ Data Set 9OtherPOLICYHOLDER'S RELEASE (For Individuals or Corporations)
Date
Unknown
Source
DOJ Data Set 9
Reference
efta-efta00283046
Pages
1
Persons
0
Integrity
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
POLICYHOLDER'S RELEASE (For Individuals or Corporations)
McLarens File #008.0201
MG Claim #:610421
CLAIM NUMBER
PCG 0021940015
POLICY NUMBER
IN CONSIDERATION of
One million dollars and no cents
1,000,000.00
and other good and valuable considerations to me/us paid, the receipt whereof is hereby acknowledged, Uwe,
JEFFREY EPSTEIN
(being of lawful age) do hereby release and
forever discharge
AIG Property Casualty Company, Insurance Office Central Ohio and McLarens
heirs, administrators,
Executors, successors and assigns, from any and all action, causes of action, claims and demands whatsoever for, upon, or by reason of
any damage, loss or injury and all consequential damage, which heretofore have been or which hereafter may be sustained by me/
us in consequence of Hurricane Maria and Hurricane Irma caused damage to fine art and jewelry.
IT BEING FURTHER AGREED AND UNDERSTOOD, that the payment of said amount is not to be construed as an admission
of liability, but is a compromise of a disputed claim and that this release is executed in MI settlement and satisfaction of rights of
the undersigned under Policy No. PCG 0021940015
arising out of loss
above referred to.
said
WITNESS my/our signature
and seal
this
day of
, 20
Witness
Witness
CAUTION: READ BEFORE SIGNING
ACKNOWLEDGMENT
FOR INDIVIDUALS
State of
State of
K ss.:
County of
County of
Officer
FOR CORPORATIONS
K
SS.:
On the
day of
, 20
On the
day of
before
me
before me came
came
to me known to be the individual described in, and who
executed, the foregoing instrument, and acknowledged
that
Executed the same.
s/he resides in
; that
,20
(SEAL)
(SEAL)
to me known, who, being by me duly sworn, did depose and say
that
Notary
s/he is the
of
, the
corporation described in, and which executed, the foregoing
instrument; that s/he knows the seal of said corporation; that the
seal affixed to said instrument is such corporate seal; that It was
so affixed by order of the Board of Directors of said corporation;
and that s/he signed her/his name thereto by like order.
Notary
EFTA00283046
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