 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 Disclosure3 L& C4 v6 v$ E
Final Settlement' u* O3 z/ n8 K5 i3 h( S1 `0 W
7 F5 o4 x. E! vCAR A:
: A) Q$ g8 ^' o6 w0 x6 C% WYear -9 L3 ^5 y) K2 ?3 q0 s/ k4 t, H
Maker/Model - l; [; U" Y7 k6 v- Q7 V
Serial (VIN) # -
9 F% H( o' u% ^3 ]8 ^8 xPlate Number:3 ^* [* r! f8 T/ t5 W" n, ^
Driver Name: (called driver A in this document), `* b8 k7 J; a* Z
( i0 A- j# @1 E$ r ^* ^& NCAR B:5 c: @( ^* M4 ^) }' y/ O0 U
Year -
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* Y Q/ F1 {7 G& I$ WSerial (VIN) # -7 G; b) `: Y* ~8 m2 l- C% r' J* |
Plate Number:3 m: i5 U ]( S0 p, Z6 ?1 `
Driver Name: (called driver B in this document)$ S2 E7 x: m, o D% e' M: J
0 R3 ~ y. l: L" t+ ^4 a7 t* ?6 rIn the afternoon of Nov. 7th, 2007, car B hit the back of car A.
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8 g y+ v- W! u" S4 Z, ]The driver B has paid
7 |& E9 O& h. [) ~1 w g1. Bumper repair: $
$ k# o) m! R7 e+ P* U2. Other Compensation: $, N: c. n# h3 K' p
% j& ]1 C, d; q% I: Wdriver A and driver B agree to make a final and permanent settlement of this accident. Driver A has received the above amount of money. And Driver A agrees with this final settlement and is forever giving up the right to claim any responsibility of driver B or to proceed to judicial review by a court, concerning any result of this accident for damage of car A or injury of anyone in it.' b! s7 Z, O/ V0 }0 ]; w7 Y$ X
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Driver A:: r3 Z" M0 {; L- Y
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Signature Date:
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Driver B:. N) C# \0 E A* u8 Z! ]
) k3 ~: H+ Q8 v( V2 I TSignature Date:
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Witness:) r8 ^. _1 }& d3 S9 Y& a
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Signature Date: |
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