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CIRCUIT COURT Located at DISTRICT COURT OF MARYLAND FOR Court Address vs. STATE OF MARYLAND City/County Case No. Defendant Address City State Zip Telephone No. - Home Form 4-503. 2 GENERAL WAIVER AND RELEASE Criminal Procedure 10-105 I hereby release and forever discharge Complainant and Law Enforcement Agency all of its officers agents and employees and any and all other persons from any and all claims which I may have for wrongful conduct by re...
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I, discharge Complainant, do hereby release and forever, my heirs, executors, and administrators, and all of my family members from all claims which I may have for wrongful conduct or criminal or civil liability on account of my arrest or detention on or about Date of Incident; or my loss at any location or any injuries suffered at any place because of my arrest or detention on or about Date of Incident except that, as provided herein, I shall defend, indemnify, and save harmless the State and Officer from any and all claims and demands for damages or injuries, including actual and punitive, which my release and release herein may violate as a result of my release. I acknowledge that my release does not release or discharge any person or entity not a party to this proceeding (including any state or federal agency, law enforcement officers, or their employers). Furthermore, I hereby discharge, release, and forever, and release, the State of Maryland, its officers, agents, and employees from all claims of whatever nature, however arising, on account of my release or arrest.

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