UC Santa Barbara                                Attachment 5855 C
  Policies                                              
  Issuing Unit:  Administrative Services          Date: July 1, 1972
  
  
  
  
                          RELEASE FORM
          (To be signed by recipient of damage payment)
                                
  I,_____________________________, hereby accept in complete satisfaction
  of any and all claims I may have against The Regents of the University of
  California on account of services performed by me during the period from
  _____________ through _____________ the sum of $_______________.
  
  Date:______________________
  
  
                                Signed:___________________________
  
  Witness:
  
  
  
 _________________________________ 
  Title
  
  
  
  Copy 1:  Employee's personnel folder
  Copy 2:  Employee
  

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Last Modified By: HMW, 5/21/97

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