 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! q6 y* B! W2 w' j1 j9 r, d6 g
Final Settlement
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" {; m4 f8 F7 e5 BCAR A:% j7 D- X) l( _! C G6 d% c- ?9 r
Year -
: z' S- b2 o' r! B# PMaker/Model -- _$ D. i3 M7 v3 f1 ]+ `
Serial (VIN) # -
2 v8 f Y3 l, {& N4 gPlate Number:
" x' k! l/ i% SDriver Name: (called driver A in this document)! F" g: g& f4 }
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CAR B:
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Maker/Model –
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$ a# v, e+ a0 _7 P1 qPlate Number:0 n8 A9 `1 P1 H' z( m$ l. T
Driver Name: (called driver B in this document)
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( d' {* V+ T3 e% Q0 }+ BIn the afternoon of Nov. 7th, 2007, car B hit the back of car A.: j4 i; z# u# c
; W$ @6 R5 y6 X3 U7 lThe driver B has paid
& B' {5 d i7 E% I: |5 l1. Bumper repair: $( f6 ]6 G9 t b6 k$ [
2. Other Compensation: $' r4 d2 D0 \3 ?
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driver A and driver B agree to make a final and permanent settlement of this accident. Driver A has received the above amount of money. And Driver A agrees with this final settlement and is forever giving up the right to claim any responsibility of driver B or to proceed to judicial review by a court, concerning any result of this accident for damage of car A or injury of anyone in it.# {% Y# ~# b4 }5 R7 n
) l1 m+ f! C5 X2 v4 U, mDriver A:. a( `* z# y3 p
1 I1 c: S8 K. z$ D3 ?: _Signature Date:$ O p3 ^! w! k9 K; S4 X
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" c8 r, X: y Y! K4 ~$ @Driver B:2 {* X( l& i/ S& C- Y# u
6 [# d8 c+ l! M% z' CSignature Date:- j& x$ Y' o5 Z2 P4 E- d
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) `6 G. _7 g8 _$ C* sWitness:
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Signature Date: |
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