RELEASE OF INTEREST IN PROPERTY INSURANCE POLICY

[DATE, ex. Wednesday, June 11, 1998]

[NAME, COMPANY AND ADDRESS, ex.
John Smith
XYZ Inc.
1234 First Street
Suite 567
Anycity, Anystate 85245]

Dear [NAME, ex. John Smith],

The undersigned hereby releases any interest it may have in and to any insurance coverage or proceeds relating to the property located at [DESCRIPTION OF PROPERTY].

Sincerely,

[YOUR NAME, ex. Jill Jones]