 鲜花( 3)  鸡蛋( 0)
|
这里有一份
自己酌情改改就可以了。0 t M$ q# q) n, r& o6 f- V
( ?$ t; ?& B+ a1 }, X) _Settlement Disclosure
( C5 x/ b, Y `: m' i, B! r6 NFinal Settlement
2 S- D. i9 \' R! y
+ z2 S+ g' S, v( C, U( s6 pCAR A:
- ~, D6 P# k2 r4 O+ I, {& W3 BYear -, Z2 r$ n1 p: c# X- ]
Maker/Model -
' s/ G0 ?) C5 t( y& p( q/ tSerial (VIN) # -( m* M# ^4 M0 q. l6 V
Plate Number:# f' j% S$ n z
Driver Name: (called driver A in this document)
5 x& U: ]1 [: }9 S. r5 |7 ~- U& f
3 n3 n ]' G' Y5 e/ ~* r! CCAR B:
5 a' T+ M* m( z8 {Year -
+ n* Q, j8 `8 r/ u8 IMaker/Model –8 ] c! G' y/ ]3 z
Serial (VIN) # -0 h; m" n1 N5 b& B% H
Plate Number:; E+ u9 i m6 z" r" [# h1 |+ F
Driver Name: (called driver B in this document)+ y3 v, u/ Z' i) n/ N, {
5 Q9 }6 ~/ y9 B# r& `% G8 d
In the afternoon of Nov. 7th, 2007, car B hit the back of car A.
: ` O' |$ \, K% A& z! y8 [+ Z0 x( i3 o! Q, P9 X
The driver B has paid# _% K( T6 y& K/ |
1. Bumper repair: $" V- @5 K3 w6 F0 Z
2. Other Compensation: $
# N( M! [5 |0 j& a" G6 t' e) b: }/ S+ X O5 G m- x0 P
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.% R1 \% R! l+ Y& c0 o* M
}* A z+ _9 m$ j; j1 eDriver A:
% {8 p# X' m' o/ s# s% }' V
G/ g q& X5 a2 BSignature Date:
7 M1 o4 y+ e) I( }' ~" D4 Z
! y% r0 Z- N2 e# `' V; U
, b7 T' w$ z+ @5 w# g- zDriver B:1 K7 U ]7 B" Y0 A0 B
, O( I5 _( z5 z% x, [Signature Date:
3 @5 T) F9 ?3 ~3 K ?3 g
3 A2 p+ o9 l, N) h6 x# A2 P* T2 \8 M9 V$ C* w8 y
Witness:9 V6 E/ C: Y8 S, L1 j" ]
# {0 n" ?! ~1 e% B+ D6 F4 _$ o% `" ^Signature Date: |
|
狗仔卡
发表于 2008-3-11 09:16
提升卡
置顶卡
沉默卡
喧嚣卡
变色卡
显身卡
楼主
