 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
0 P1 N/ O5 ? o8 ]. d" j% XFinal Settlement1 a! L2 @+ t" i' F# a
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Year -
6 X' e/ ?; S+ e9 l. }! ]9 lMaker/Model -
! l6 A0 r, j% M8 m; X% M: v9 ~Serial (VIN) # -/ b* h0 F5 t# L
Plate Number:
$ h7 }* [8 s! H* c5 x6 b& dDriver Name: (called driver A in this document): J% G D/ y& w, W8 k
. Z Z1 ? t, C% b. u$ N5 hCAR B:( d( \( L" A8 l- c
Year -4 T+ a9 t; Q( m
Maker/Model –
' K+ j/ N# O* j! C4 Y8 o/ sSerial (VIN) # -
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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.0 E/ l& x; x7 t/ T8 t0 J
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The driver B has paid
$ [3 S, R6 C1 ^1. Bumper repair: $9 U) Q* F6 p, l; W( G- P+ k& z r
2. 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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( ~# l$ c0 Y3 o P$ m1 ~; c# jSignature Date:
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Driver B:1 ^$ A) q& W/ m+ ~: \
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Witness:: M8 U. a# v; \& Y
; o5 Q2 B( T6 ?! O6 N5 O+ t! uSignature Date: |
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狗仔卡
发表于 2008-3-11 09:16
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