INDEPENDENT CONTRACTOR TERMINATION NOTICE
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Effective Date: ________________________________________________________
Place: _________________________________________________________________

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1. Parties
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This document is made on ____________________ (____________________) by:

Client
Individual
Full Legal Name: _______________________________________________________
SSN / ID: ______________________________________________________________
Doc Series: ____________________________________________________________
Address: _______________________________________________________________
         _______________________________________________________________

Addressed to:

Contractor
Individual
Full Legal Name: _______________________________________________________
SSN / ID: ______________________________________________________________
Doc Series: ____________________________________________________________
Address: _______________________________________________________________
         _______________________________________________________________

2. SUBJECT-MATTER SCHEDULE & SPECIFICATIONS
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Contract Being Ended (Title & Date):
    ____________________________________________________________________
Termination Effective Date: ____________________________________________
Reason for Termination: ________________________________________________
Final Payment & Deliverables: __________________________________________
Return of Materials & Access: __________________________________________

3. EXECUTION & SIGNATURES
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Client

Signature: _____________________________________________________________

Full Legal Name: _______________________________________________________
Date: __________________________________________________________________