Helping Individuals Who Have Been Hurt By Others

Authority To Represent – Severance Agreement

I understand that Roxanne Conlin & Associates, P.C. agrees to negotiate a severance agreement for me from my employer or former employer_____________________________. I do not wish to pursue a lawsuit at this time, but I wish to seek a fair severance and use the services of Roxanne Conlin & Associates, P.C., to negotiate/advise/strategize on the severance agreement. I understand that if a severance agreement is signed by me, I will give up all rights to sue the employer and co-employees.

Roxanne Conlin & Associates, P.C. agrees to represent me and I agree to retain their services as attorneys under the following terms:

1. My attorneys will exercise their best efforts on my behalf and will not settle my case without my permission.

2. My attorneys will expect me to work on my case, to answer their calls and supply them with complete and accurate information. My attorneys will also expect me to cooperate with them in all reasonable requests. The failure to cooperate will permit my attorneys to withdraw from representing me.

3. I will pay my attorneys 40% of the value above the first offer of settlement which was $_____, plus any costs incurred. Benefits will be valued at 20% of the annual salary unless otherwise agreed. Any amount designated by Defendant to pay attorney fees shall be added to total and 40% of the total will be paid for the attorney fees.

4. My attorney will advance costs on my behalf. All costs advanced by my attorney will be repaid by me from my share. Costs include filing fees, depositions, experts, copying, travel expenses and the like.

Note: There may be other costs associated with the matter but which are not considered to be costs of the lawsuit. Examples of that type of expense include such things as opening an estate, fees to tax advisors and all expenses for medical treatment.

5. I have the right to terminate my attorneys’ services and this Agreement at any time. I will, however, still owe my attorneys any money due at the time I give my attorneys notice of my decision. That will include advanced costs and the recoverable hourly rate already expended on my case. If my attorneys have negotiated a settlement which I do not wish to accept, I may owe them 40% of the amount negotiated in the event of recovery.

6. My attorneys have the right to withdraw from representing me if a) I insist upon pursuing an objective that is imprudent; b) I make representation unreasonably difficult or unethical; c) I fail to disclose information after being asked to do so or disclose false information; d) I fail to cooperate in pursuing my case; or e) other good cause for withdrawal exists. My attorneys do not give up their right to withdraw even where my attorneys continue to represent me after an event permitting withdrawal.

7. At some point during the course of legal representation, a settlement proposal may arise which my attorney believes to be a just and reasonable resolution of my claim(s). Such a determination shall depend on my attorneys’ evaluation of the combination of the harm and financial losses suffered by me, the state of the applicable law, and the likelihood of prevailing at trial. If my attorney recommends a settlement proposal as just and reasonable and I refuse to accept said proposal, my attorney shall have the right to withdraw from my case and shall be entitled to the higher of the current hourly rate and all costs incurred to date or 40% of the last settlement offered to client.

8. It is agreed that my attorneys have made no guarantees concerning the outcome in this matter.

9. I understand that in the event a complaint is filed with the Iowa Civil Rights Commission or any other state or federal agency or a lawsuit is filed, this agreement is canceled and the standard employment contract is in effect thereafter. The standard employment contract requires payment of 40% of all amounts recovered by trial or settlement.


DATED at Des Moines, Iowa, this _____ day of _________, 2016.


ACCEPTED: _____ day of ___________________, 2016.

By: ____________________________________