 鲜花( 3)  鸡蛋( 0)
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这里有一份
自己酌情改改就可以了。 |: M e, c# f2 }8 R
: o0 J# f C3 `; d" o( FSettlement Disclosure9 `' @8 ~* G! j5 m
Final Settlement+ l8 t" ^# d1 q4 U l5 Y
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CAR A:
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Maker/Model -
9 e$ v7 I0 B8 N7 A- l3 z8 lSerial (VIN) # -
: z4 h' g: w* NPlate Number:
) h2 B3 H: M l" L* F1 C fDriver Name: (called driver A in this document)
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CAR B:
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Maker/Model –2 E0 }, d8 x6 s
Serial (VIN) # -
) \; y8 }) s; @: }- v) TPlate Number:
- T0 F! a& f/ A1 |8 P( W; E0 V; ZDriver Name: (called driver B in this document): [# u# ^+ }( a6 x* B$ J5 v, x
2 |' C9 ~; P: F) }/ |In the afternoon of Nov. 7th, 2007, car B hit the back of car A.
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" [+ n( D7 Z" L" c8 k: v1 ZThe driver B has paid
% s3 {: ]: W* R1 s f4 G+ Z' B1. Bumper repair: $2 {& p& \$ |* V J) g/ n3 F0 @
2. Other Compensation: $* j2 M' f, B- }4 G* s8 j7 t- T
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driver A and driver B agree to make a final and permanent settlement of this accident. Driver A has received the above amount of money. And Driver A agrees with this final settlement and is forever giving up the right to claim any responsibility of driver B or to proceed to judicial review by a court, concerning any result of this accident for damage of car A or injury of anyone in it.- x" A& Y6 F6 C) v. Y) G% U
# {1 ~$ R& V t3 uDriver A:
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Signature Date:
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Driver B:3 z) z* y) \* I8 P8 }0 _( u) l
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Signature Date:
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Witness:
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* k/ J- ]7 H! {9 d; USignature Date: |
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