Notice of Rescission of Release

TO ____________________________

Notice is hereby given that the undersigned,______________,
rescinds that certain release executed by him on (date) ,
whereby he released you from any and all claims arising out
of (subject for which release was executed), on the
following grounds:

The undersigned agrees to restore to you total consideration
received by you for his execution of the release, including
(consideration received).

Dated: (Signature)

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