 鲜花( 3)  鸡蛋( 0)
|
这里有一份
自己酌情改改就可以了。
% D3 {; V( L# I' J+ n
$ x- b9 O$ h8 k2 K/ e5 oSettlement Disclosure( r2 g j0 a9 v7 X3 J
Final Settlement- T2 J3 y$ Z( }; i5 o! P$ K) T5 _
G1 Q( M" J7 p# RCAR A:# E a1 J* P# {6 d
Year -
1 w3 l( G5 w( a$ l' k5 ~Maker/Model -
: `& r/ j3 V5 F! r5 J' GSerial (VIN) # -
! l# i- A3 m) t+ F/ w; y2 pPlate Number:
: c' S8 k6 K6 C+ bDriver Name: (called driver A in this document)% V( K8 K$ O# i: S a" ?1 i
( l, D5 t K& |! D4 `
CAR B:% l0 [9 j: O( r- k( q6 C
Year -
' p' @# B) x$ z9 i( @1 jMaker/Model –7 M9 u6 E8 g: G9 X2 C
Serial (VIN) # -
O! J1 l2 g Y$ Y0 }0 V e1 qPlate Number:
2 [7 ~; |5 \ O7 KDriver Name: (called driver B in this document)
5 N. c' ?4 z9 F- ?& F L2 z3 T- w# X8 m; Z1 H. w
In the afternoon of Nov. 7th, 2007, car B hit the back of car A.8 e+ o& q7 `( P% \- d& w! L V! }
~- V- P( K/ \" H. iThe driver B has paid& O6 v) L6 t: h B# f* Q I, P+ B y
1. Bumper repair: $2 z. ^! F h6 |# R2 H
2. Other Compensation: $
/ E' f/ F9 Z& c- S
4 n; x. r3 r% }4 gdriver 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.
4 L) x: E1 M# s7 R( b% G; E U0 R* P2 p7 t0 `( q: v- J
Driver A:) v1 h! c" q5 B! D* P
5 U5 F, z( w$ }7 ?3 b/ f8 @2 A
Signature Date:% c0 _/ U0 q2 z$ H$ d) e4 [
5 d, o9 t0 Y! Y& _, K( \) r7 `7 e0 b6 r
Driver B:+ r+ F2 x! Y8 G! }6 }
# X3 w$ T/ K- J6 m8 m1 PSignature Date:) |0 z) M1 C: Y. r/ g3 O
/ ]; c/ ^% x* x# j7 d
8 E' t2 F2 A: o5 C3 g) W1 jWitness:+ q9 {: S) j0 m8 Q" S3 B2 D
A8 K5 X% `3 O; Z% u u% ~
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
