 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。
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( z$ W' S! d8 S5 S" hSettlement Disclosure5 _$ V5 r. f8 I/ }7 k- Q" h/ I5 y: j+ a
Final Settlement8 _5 X6 c/ }1 @- c
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CAR A:! D v' s& c6 E% E; U, S
Year -
4 b3 o' I& f, [5 S; a3 w/ RMaker/Model -
6 X6 B; L' J; ?Serial (VIN) # -
& h5 t; J: a" a. lPlate Number:
/ z" n5 u4 v+ T3 QDriver Name: (called driver A in this document)
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CAR B:
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Maker/Model –6 v8 H. F3 K! a# ]; H' G
Serial (VIN) # -
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Driver Name: (called driver B in this document)
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3 @( O9 J- A; Z% u) o# v/ w! k6 Z IIn the afternoon of Nov. 7th, 2007, car B hit the back of car A.! Z; W( ]5 W$ m# i) s) U5 Q
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The driver B has paid: C* S2 P- R& |1 u; q+ q9 N! ]0 e
1. Bumper repair: $
! I4 X: Z, ~0 k$ t+ n* g3 d( Q2. Other Compensation: $! Y% u3 _4 S) ~3 h& \# E8 a# x
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driver A and driver B agree to make a final and permanent settlement of this accident. Driver A has received the above amount of money. And Driver A agrees with this final settlement and is forever giving up the right to claim any responsibility of driver B or to proceed to judicial review by a court, concerning any result of this accident for damage of car A or injury of anyone in it.- F7 d& D5 {/ L% z- \, U( j4 ^
1 i4 M$ s) G i9 M3 o R" [/ IDriver A:; w, f/ o7 _; r" m
' _1 c% ?: @( tSignature Date:
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Driver B:
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Signature Date:. c+ u! X. @& ^
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+ \/ G$ c G: i/ l. w8 |9 I' UWitness:
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{1 t* n$ ], ]* VSignature Date: |
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