Damage Claim Assignment

Date: ___________.

FOR GOOD AND VALUABLE CONSIDERATION, receipt of which consideration is hereby acknowledged, I/we do hereby convey, pass, and assign to ___________________ ("Assignee"), as evidenced by my/our signature below, all and any of my/our ownership rights, interests, and claims of any type in the matter, more specifically described as: __________________.

The assignor represents the rights and interests of the above matter as being fully and completely assignable. Further, the assignor guarantees that the above matter has not been settled. The assignor additionally agrees to provide all reasonable assistance to the Assignee in pursuing the above-described claim.

________________________

Assignor

________________________

Assignee

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