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I further warrant that I will institute no further action against the said
_____________ arising from, by reason of, or in connection with, the
aforementioned vehicular accident. I also manifest that the said payment /
settlement made by the said _____________ shall not be taken by me, my heirs,
my insurer or assigns, as a confession and/or admission of liability on the part of
the said _____________ in connection with the aforementioned accident.
AFFIANT
ACKNOWLEDGEMENT
IN WITNESS WHEREOF, I hereunto set my signature and affix my notarial seal the day,
month and year first above-written.
Doc. No._____;
Page No._____;
Book No. _____;
Series of 2018.