[l-Date]
To:
[r-Name]
[r-Company]
[r-Address]
From:
[s-Name]
[s-Company]
[s-Address]
[s-Phone]
RE: [s-Reference]
Dear [r-FName]:
Notice is hereby
given that the undersigned, [r-Name], rescinds that certain release
executed by [him/her] on [s-ExecDate], whereby [he/she] released you
from any and all claims arising out of [subject for which release was
executed], on the following grounds:
[s-InsertGrounds]
The undersigned
agrees to restore to you total consideration received by you for his
execution of the release, including [s-Consideration].
_____________________________ ________________
Signature Date
