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Lump sum child support agreement template

Lump sum agreement template 2026

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FORM 116B is an addendum to a lump sum settlement agreement related to vocational rehabilitation status in Massachusetts. It outlines conditions under which written consent from the Office of Education and Vocational Rehabilitation is not required for the validity of the agreement, including employee suitability determinations and employment status. The document also clarifies that lump sum agreements do not affect liability for medical or vocational rehabilitation benefits.

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Click ‘Get Form’ to open the lump sum agreement template in the editor.
Begin by entering the DIA Board number if known, followed by the employee's name in the designated fields.
In Part A, select one of the options regarding vocational rehabilitation status by checking the appropriate box that applies to your situation.
Sign and date the form in the provided signature section, ensuring all information is accurate before proceeding.
If applicable, complete Part B by noting any relevant details regarding vocational rehabilitation services and obtaining necessary consents.
Review Part C for important notes on liability and ensure you understand your rights regarding medical benefits and vocational rehabilitation.

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