Moving and Relocation Expense Agreement

[Company name] is providing in its offer of employment a moving and relocation lump-sum payment of $[amount] to [Employee name]. This amount will be paid to [Employee name] with his or her first paycheck on [date].

I, [Employee name] agree to reimburse [Company name] if I voluntarily terminate my employment prior to the completion of two years of service according to the following rates and schedule:

100% if employed for less than 6 months

75% if employed for 6 months but less than 12 months

50% if employed 12 months but less than 18 months

25% if employed 18 months but less than 24 months.

I also acknowledge that this payment provided for non-deductible moving and relocation expenses and will be included in my gross income as wages and subject to withholding of all applicable taxes.

I hereby certify my acceptance of the payback rates and schedule listed above and agree to reimburse [Company name] in the event of my voluntary termination prior to the completion of two years of service. I understand that my employment with [Company Name] is considered at-will, meaning that either the company or I may terminate this employment relationship at any time with or without cause or notice.

Employee name: ________________________________________________

Employee signature _____________________________ Date ____________

Witness name: __________________________________________________

Witness signature:  ______________________________ Date ____________