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Date :
[Select and
type recipient's address]
EMPLOYMENT
REIMBURSEMENT AGREEMENT
The
undersigned officer or employee of _ [Company],
agrees to repay to the Company all compensation
payments or reimbursements that are disallowed, in
whole or in part, as a deductible expense by the
Internal Revenue Service. The reimbursement shall
be made to the full extent of the disallowance
upon an adverse decision of the last tribunal or
agency to consider the issue, provided the Company
shall not be obligated to seek further appeal if
available.
Signed under
seal this _ day of _, 20_.
[Select and
type your name]
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