This form can be provided to an exiting employee to confirm in writing that the employee has not suffered any undisclosed injuries, illness or other related employment matters except as otherwise noted.
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Claim Statement_1.TRMC.0007.01.pdf
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Note: This sample form is provided as a tool for employers. This form is general in nature, and may not be required by law. ManagEase is not a law firm. This form does not constitute legal advice, nor is any attorney-client relationship created or implied. Prior to using this form, we recommend that you consult with an attorney knowledgeable in any potentially applicable federal and/or state laws regarding the specific intended use of this form. 
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