Registrant's Form of Separation Agreement (with salary continuance)



 EXHIBIT 10(a)(1) 

 

 

  

			
		  	Sender’s Name
		  	Sender’s Title
		  	Operating Company
		
		  	Xerox Corporation
	Date	  	Sender’s address
		
		  	email.address@xerox.com
		  	tel    000.000.0000
		  	fax    000.000.0000

 First Name Last Name 
 Title 
 Street Address Line 1 
 Street Address Line 2 
 City, State ZIP 
 Dear Addressee: 
 The following information summarizes the
arrangements for your retirement from Xerox Corporation (the Company). 
 Last day of active employment: 
 Salary Continuance Period: 
 Salary
Continuance Amount: 
 Retirement [or Separation] Date: 
 Notwithstanding anything else contained in this letter, if you (or those acting in concert with you) engage in Detrimental Activity as defined in the attached Exhibit, the consequences set forth therein shall
apply. This agreement is subject to the approval of the Compensation Committee. 
 Summarized below are the relevant provisions of the plans and programs
in which you participate that apply to your long-term incentive awards, 401(k) savings accounts, pension benefits, life insurance benefits and other benefits arrangements. 
 [If retirement eligible]Assuming that you will have met the age and service conditions of such plans and programs, you will be treated as a retiree for the purposes thereof effective on your Retirement Date.

 Stock Awards 
 Stock grants (including stock
options) awarded to you prior to the commencement of salary continuance shall continue to vest and/or remain exercisable per the terms of the awards and the relevant plans during your Salary Continuance Period and retirement [or separation]. [You
will not be eligible for additional stock awards in 200X]. 
 Deferred Compensation Plan [delete if not applicable] 
 Your deferred compensation accounts will be paid out according to the terms of your prior elections. 
 401(k) Savings Account 
 Under relevant plan provisions, you have choices available regarding the continued
investment of your account balances and the time [if retiring add this: and form] of distribution. As a result of IRS regulations, you will not be








 
able to make deferrals into the 401(k) plan while on salary continuance. At the end of your salary continuance period you will have the opportunity to elect how and when the proceeds of your
401(k) will be distributed. Information on these choices will be sent to you by the Benefits Center upon [retirement or separation]. 
 Employee Stock Ownership Plan (ESOP) 
 As an active employee, you can only take a distribution of ESOP in stock. At separation,
your ESOP account can be taken as cash, in stock, or rolled over to the Xerox 401(k) savings plan or your IRA, or you may defer settlement with the plan. 
 Pension Benefits (if eligible) 
 [If retirement eligible and a RIGP participant] Effective
on your retirement date, you will become a retiree of Xerox. As a retiree, you will receive pension benefits accrued in the Retirement Income Guarantee Plan (RIGP). Your RIGP benefits are projected to provide a lump-sum value of approximately [$X].
Please keep in mind that this is only an estimate and that the actual benefits paid will be per the terms of the plan. 
 [If SERP eligible] In
addition to your vested RIGP benefit, you will be eligible to receive a benefit under the Unfunded Retirement Income Guarantee Plan (URIGP) and the Unfunded Supplemental Executive Retirement Plan (SERP). Your retirement income benefits under URIGP
and SERP are unreduced for commencement at age 60 or later will be offset by your RIGP benefits. Payments will commence at the end of [Month /Year]. As a result, your first payment will equal 7 months worth of payments to include the first 6 months
of your Salary Continuance Period plus your [enter 7th month of payment] payment and will reflect your survivor election. All payments will be made in monthly installments on the last day of each month. [For non-US officers: The final SERP amount
you will receive will be reduced by certain amounts payable in the same year by the Company or any subsidiary of the Company, as provided under SERP including but not limited to any pension, retirement or post-retirement corporate or statutory
benefits that you may receive.] Your URIGP and SERP benefit is estimated to be approximately [$X] per year (based on a 50% joint and survivor annuity). Please keep in mind that this is only an estimate and does not reflect taxes owed. The actual
benefits will be paid per the plan’s terms. These URIGP and SERP benefits are unfunded and not tax qualified. This means you are an unsecured general creditor of the Company with respect to these benefits. 
 [If URIGP but not SERP eligible] In addition to your vested RIGP benefit, depending on your age at retirement, you will be eligible to receive a benefit
under the Unfunded Retirement Income Guarantee Plan (URIGP). Your retirement income benefits under URIGP will be offset by your RIGP benefits. Payments will commence at the end of [Month /Year]. As a result, your first payment will equal 7 months
worth of payments to include the first 6 months of your Salary Continuance Period plus your [enter 7th month of payment] payment and will reflect your survivor election. All payments will be made in monthly installments on the last day of each
month. Your URIGP benefit is estimated to be approximately [$X] per year (based on a 50% joint and survivor annuity). Please keep in mind that this is only an estimate and does not reflect taxes owed. The actual benefits will be paid per the
plan’s terms. These URIGP benefits are unfunded and not tax qualified. This means you are an unsecured general creditor of the Company with respect to these benefits. 
 [If not retirement eligible but a RIGP participant] At separation, you will be eligible to receive vested pension benefits accrued under the Retirement Income Guarantee Plan (RIGP). A calculation of your
benefit will be completed upon separation at which time you will have the opportunity to elect how and when the proceeds will be distributed. In addition to your vested RIGP benefit, you may be eligible to receive a benefit under the Unfunded
Retirement Income Guarantee Plan (URIGP). Your retirement income benefits under URIGP will be offset by your RIGP benefits. Payments will commence after you reach age 55 or 6 months from the first of the month following your date of termination, if
later. All payments will be made in monthly installments on the last day of each month. Your URIGP benefit is estimated to be approximately [$X] per year (based on a 50% joint and survivor annuity). Please keep in mind that this is only an estimate
and does not reflect taxes owed. The actual benefits will be paid per the plan’s terms. These URIGP benefits are unfunded and not tax qualified. This means you are an unsecured general creditor of the Company with respect to these benefits.








 Medical Benefits 
 During the Salary Continuance Period, you will receive medical coverage. Such eligibility will end on the last day of your Salary Continuance Period. 
 [If retirement eligible] As a retiree, you will receive medical coverage under the Xerox Retiree Flex Health Plan or a successor plan, if any. As you get
closer to your retirement date, an information package will be sent to you from the Xerox Benefits Center. 
 Disability Benefits

 Eligibility for short- and long-term disability ends at the start of salary continuance. If you are interested in conversion coverage
under a Prudential group plan, call Prudential (1-888-262-6873) and ask about The Prudential Group Long-Term Disability Conversion Insurance Trust. 
 Bonus 
 You will be eligible to receive a cash bonus for [20XX] as determined by the Compensation Committee in early [20XX] and
payable in that year. 
 Life Insurance 
 [For former CLIP participants] You may continue in the Xerox Universal Life Plan (XUL). Upon retirement, your death benefit will be equal to [$X]. The Company will make contributions pursuant to the provisions of XUL until age 65 or July
2013, whichever is later. 
 [For other XUL participants] Upon retirement, you will receive correspondence from MetLife explaining that you have
the opportunity to continue coverage approximately equal to your Xerox Universal Life Plan (XUL) coverage of [$X]. If you choose to continue coverage, MetLife will bill you directly. 
 Other Arrangements 
 You will relinquish your position as an Officer of Xerox Corporation
and as a director and officer of any subsidiary company as soon as administratively feasible after your active employment ends. At the appropriate time, a representative of Xerox Corporation will contact you regarding your resignation as a Corporate
Officer. 
 You will be paid for any accrued and unused vacation upon commencement of salary continuance. You will not accrue any further
vacation during salary continuance. 
 Your Company financial planning assistance will be continued through the tax year in which your active
employment ends. 
 You will also be eligible for your physical under the Executive Physical Program through the calendar in which your active
employment ends. 
 For the Xerox sponsored employee benefit plans summarized in this letter, if there is a discrepancy between this letter
and the official plan documents, the terms of the plan documents govern. 
 Indemnity 
 You will be entitled to be indemnified with respect to all periods of your service as a director or officer of the Company or any of its subsidiaries in
accordance with 1) the provisions of Sections 721 through 725 of the Business Corporation Law of the State of New York and provisions of California Labor Code Section 2802 2) Section 2 of Article VIII of the by-laws of the Company as in
effect on the date of commencement of salary continuance and 3) the Company directors and officers liability insurance policies with Federal Insurance








 
Company, XL Specialty Insurance Company, St. Paul Mercury Insurance Company, Twin City Fire Insurance Company, U.S. Specialty Insurance Company, Arch Specialty Insurance Company, ACE American
Insurance Company, Allied World Assurance Company and Axis Reinsurance, or any replacement or substitute thereof or any addition thereto. 
 Release 
 The salary continuance payments, or any other consideration provided for in this letter, shall not become effective
unless you execute and deliver to the Company the release in the form attached immediately prior to the scheduled commencement thereof. Any amount otherwise scheduled to be paid on any date shall not be paid, and shall be forfeited, unless the
release has been delivered to the Company by such date. 
 Cooperation in Litigation 
 You will cooperate fully, without additional compensation, with the Company and its counsel in any litigation that arises out of or is related to your
service with the Company or any of its subsidiaries, or in which you are named as a party. That cooperation includes making yourself available for reasonable periods of time upon reasonable notice for consultation with the Company’s counsel in
any such litigation, promptly notifying the Company’s General Counsel if you are subpoenaed or requested by a third party to testify or to be interviewed in connection with any such litigation or legal preceding, and testifying in such
litigation. 
 Heirs, Successors or Assigns 
 This agreement and any rights, responsibilities and obligations hereunder shall be binding upon any heirs, successors or assigns. This agreement shall not be assigned without prior written notice to and
consent of the other party to this agreement. 
 Sincerely, 
 [Manager’s Name] 
 [    ]/cd 
  

	
	AGREED AND ACCEPTED
	
	  

	Employee Name
	
	  

	Date










			
	Name:	 	  



  

			
	Employee #:	 	  



  

			
	SSN:	 	  



 GENERAL RELEASE 
  

	1.	In consideration of Xerox Corporation’s (“Xerox”) agreement to provide me with
                 weeks of salary continuance, if any, and other valuable consideration, [including but not limited to [describe the consideration provided here]] as set
forth in the letter agreement dated [provide date here]
I,                                         
                   , release Xerox from all the claims described in this Release. For purposes of this Release, “Xerox” includes its employees,
directors, officers, agents, stockholders, subsidiaries, affiliates, successors, assigns, and the Xerox employee benefit plans in which I either am now or have been a participant, and the trustees, administrators, successors, agents and assigns of
those plans. 

  

	2.	I release Xerox from any and all claims, even if I don’t know about the claim at this time, based on anything that has occurred prior to the date I sign this
Release. For example, I release Xerox from any claims based on all laws, such as the following (all laws as currently amended): 








 Age Discrimination and Employment Act of 1967 (ADEA) 
 Older Workers’ Benefits Protection Act of 1990 (OWBPA) 
 Title VII of the Civil Rights Act of 1964 
 Civil Rights Acts of 1866, 1870, 1871
and 1991 
 Americans with Disabilities Act of 1990 
 Rehabilitation Act of 1973 
 Family and Medical Leave Act of 1993 
 Equal Pay Act of 1963 
 Fair Labor Standards Act of 1938 
 Employee Retirement Income Security Act of 1974 
 Worker Adjustment and Retraining
Notification Act of 1989 
 Uniformed Services Reemployment Rights Act of 1994 
 Vietnam Era Veteran’s Readjustment Assistance Act of 1974 
 I also release Xerox from claims based on the laws of the state(s) where I am employed and reside, such as state fair employment practice laws or any other law, whether federal, state or local, concerning
employment. I release Xerox from claims based on discrimination in employment such as claims arising out of the offer of employment to me by Xerox, the hiring of me by Xerox, any employment contract between Xerox and me, any promises made by Xerox
regarding future employment, or based on the termination of my employment. Finally, I also release Xerox from claims under state contract or tort law, and from all claims for punitive or compensatory damages, costs or attorney’s fees.

  

	3.	I acknowledge and agree that the consideration set forth in this Release is in addition to anything of value to which I am entitled by law or Xerox policy.


  

	4.	I understand and agree that this Release and Xerox’s agreement to provide consideration to me should not be construed, in any way, as an admission by Xerox of any
wrongdoing or liability to me. 

  

	5.	I understand that nothing set forth in this Release limits my right to file, or prevents me from filing, a charge or complaint with the EEOC or any comparable state
agency, nor does anything in this Release limit my right to participate in an investigation or proceeding conducted by the EEOC or any comparable state agency. 

  

	6.	I understand that nothing in this Release limits my right to challenge this Release as not being knowing and voluntary under the ADEA or the OWBPA if I feel this
Release does not comply with the requirements of those statutes. 

  

	7.	Except as provided in paragraphs 5 and 6 above, however, I agree that I will not file or pursue any charge or claim with any governmental agency or any court against
Xerox based on anything that occurred before I signed this Release. If I do not comply with my obligations under this paragraph, I shall repay to Xerox upon demand all of the monies paid to me by Xerox as salary continuance in consideration for this
Release, and I agree to pay all of Xerox’s costs and expenses in defending the claim or action, including Xerox’s reasonable attorney’s fees. 

  

	8.	I understand and acknowledge that Xerox policy provides that for a period of one year after the termination of my employment with Xerox, I am not eligible for rehire as
an employee, or for retention as a contract worker or consultant. 

  

	9.	Xerox advises me as follows: 

  

	 	•	 	 TO CONSULT WITH AN ATTORNEY OF MY CHOOSING TO COUNSEL ME AS TO MY RIGHTS BEFORE I SIGN THIS RELEASE; 










	 	•	 	 TO TAKE SUFFICIENT TIME TO DECIDE WHETHER TO SIGN THIS RELEASE. I HAVE 21 DAYS FROM THE DATE THIS RELEASE IS PROVIDED TO ME TO CONSIDER IT BEFORE I
SIGN AND RETURN IT TO XEROX; 


  

	 	•	 	 THAT EVEN AFTER I SIGN AND RETURN THIS RELEASE TO XEROX, I WILL HAVE 7 DAYS THEREAFTER TO CHANGE MY MIND AND REVOKE MY RELEASE BY ASKING XEROX FOR
ITS RETURN. 


  

	10.	I understand and agree that this Release waives all claims I may have at the time I sign it, including claims I do not then know about or suspect. I further understand
and acknowledge that California Civil Code, Section 1542 provides: “A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS WHICH THE CREDITOR DOES NOT KNOW OR SUSPECT EXISTS IN HIS FAVOR AT THE TIME OF EXECUTING THE RELEASE, WHICH IF KNOWN BY HIM
MUST HAVE MATERIALLY AFFECTED HIS SETTLEMENT WITH THE DEBTOR.” I waive any rights I may have under that Code section, if applicable, or any other similar state or federal statute or common law principle of similar effect.


  

	11.	I understand that in signing this release, I thereby waive all claims of my successors, beneficiaries, heirs and assigns. 

  

					
	Date this document provided to employee:	  	  
	  	
			
	Date signed and returned to Xerox:	  	  
	  	
			
	By:	  	  
	  	
		  	Employee signature	  	








 Exhibit to Letter Agreement 
 Engagement in Detrimental Activity 
 Definition of Detrimental
Activity 
 “Detrimental Activity” shall mean: 
 (1) For one (1) year following your termination of employment with the Company, directly or indirectly (i) engaging as an employee, proprietor, partner, agent, consultant or otherwise, by any
means, in any business that is competitive with the business of the Company or (ii) engaging as an employee of or providing services as a consultant to another firm or corporation (other than the Company or an affiliate) that is a direct
competitor of the Company in any business in which the Company is presently engaged, unless the Company has previously advised in writing that it consents to such engagement ; or 
 (2) Disclosing confidential or proprietary business information of the Company, including but not limited to violating the Proprietary Information and Conflict of Interest Agreement entered into between
the Company and Employee; 
 (3) Making any defamatory, derogatory, disparaging or inflammatory statements about the Company, its management or
its business; 
 (4) Violating any rules, policies, procedures or guidelines of the Company, including but not limited to the Company’s
Business Ethics Policy; 
 (5) For a five (5) year period from your last day of active employment with the Company, directly or indirectly
soliciting, inducing, encouraging or assisting any employee of the Company to leave his or her employment with the Company; 







 (6) For a five (5) year period from your last day of active employment with the Company, directly or
indirectly soliciting or accepting business from any customer or potential customer of the Company, or soliciting, inducing or encouraging any customer, potential customer or supplier of the Company to reduce the level of business it does with the
Company; 
 (7) Being convicted of, or entry of a guilty plea with respect to, a felony, whether or not connected with the Company; or

 (8) Engaging in any other conduct or act reasonably determined by the Company to be injurious, detrimental or prejudicial to any interest of
the Company. 
 Nothing contained in this exhibit shall be construed to restrict the executive’s reporting obligations, if any. 

Consequences of Engagement in Detrimental Activity 
 If the executive who is a party to the Letter Agreement (or such individuals acting in concert with him or her) engages in Detrimental Activity to the Company, as determined in the Company’s
reasonable sole discretion, such discretion exercised prior to a change in control of the Company, the following additional consequences shall apply: 
 (a) Any outstanding equity awards under the 2004 Performance Incentive Plan, the 1991 Long-term Incentive Plan, the 1998 Employee Stock Option Plan, or pursuant to any bonus or retention plans or programs (“Awards”) shall be
cancelled and be of no further force or effect; 
 (b) Any payment of salary continuance shall terminate, any amounts paid shall be rescinded in
full by the Company and shall be repaid by the executive (or, if applicable, his or her spouse or beneficiary), the executive’s employment with the Company will terminate and any benefits described in the Letter Agreement, or otherwise, that
are dependent upon continued employment, including, without limitation, continued vesting of benefits and determination of years of service, will also terminate, and any exercise, payment or delivery of an Award within six months prior to such
Detrimental Activity may be rescinded at the sole discretion of the Company. In the event of any such rescission, the executive (or, if applicable, his or her spouse or beneficiary) shall pay to the Company the amount of any gain realized or payment
received as a result of the rescinded exercise, payment or delivery, in such manner and on such terms and conditions as may be required by the Company; 
 (c) Any unfunded retirement benefits including, without limitation, under the Unfunded Retirement Income Guarantee Plan and the Unfunded Supplemental Executive Retirement Plan, shall be forfeited; and

 (d) The Company shall have the right to an injunction or other equitable relief and to all other appropriate legal remedies, including
damages.