ASSIGNMENT OF A CLAIM FOR DAMAGES
FOR VALUE RECEIVED, the undersigned
hereby sells and transfers to [s-Name], [Assignee] and its successors, assigns
and personal representatives, any and all claims, demands, and cause or causes
of action of any kind whatsoever which the undersigned has or may have against
[s-Claim], arising from the following type claim:
[Insert claim description]
And the undersigned may in its own
name and for its own benefit prosecute, collect, settle, compromise and grant
releases on said claim as it in its sole discretion deems advisable.
Signed under seal this [s-Day] day
of [s-Month], [s-Year].
____________________________
[s-Name]
[s-Title]
[s-Company]
