 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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Settlement Disclosure
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- p1 C9 L- m6 z# V, t9 u' XCAR A:
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Serial (VIN) # -# m: x( ] T% T: r
Plate Number:( P! c/ R! K6 i* ^
Driver Name: (called driver A in this document)
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2 S8 `2 S* w5 r7 w% i9 ~% KCAR B:
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Serial (VIN) # -6 h0 d* O' r8 S* Z# A
Plate Number:- p8 D' L" p" Z0 v# j$ H. d
Driver Name: (called driver B in this document)
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In the afternoon of Nov. 7th, 2007, car B hit the back of car A.
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The driver B has paid
1 f: B$ p. @9 B) N1. Bumper repair: $
4 M, J$ U) Y3 H3 C4 T: m7 Y2. Other Compensation: $
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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.
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Driver A:
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Driver B:) z W4 {; N2 l( C' H b( _
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Signature Date:
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Signature Date: |
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