 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 h& x1 E0 O8 N, b+ w
Final Settlement* L" K# c, f, I; T% f
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Maker/Model -
: O5 D+ ]; \- V0 J5 b, x K3 `Serial (VIN) # -/ G% d- U7 m: Z0 w$ l. Q* S. A; i0 ~
Plate Number:
5 f2 f9 W- T5 v# ?: `% h1 w& h4 @# hDriver Name: (called driver A in this document)( c( L+ ?6 t7 w* l" ?
8 [* F v( l- X. p- j5 UCAR B:( S7 \. k4 T4 @2 l! u
Year -
4 J1 c. U0 n- FMaker/Model –
9 I4 v W9 P7 O( f' F3 l% rSerial (VIN) # -* Q% }, q+ M5 T5 G( t/ p' u$ y
Plate Number:
' }' O7 m" @! \1 g! |Driver Name: (called driver B in this document)
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0 z1 P: T' E% |1 v6 T" \+ `In the afternoon of Nov. 7th, 2007, car B hit the back of car A.
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: k/ A3 s% U% p. y' w' |% f, D' ?The driver B has paid
9 G# K: r$ Y" D1. Bumper repair: $
4 C( h) d' g; W" ]) }/ B2. 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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( X# F/ `9 k3 ~ y hDriver A:% q A" b; m$ b1 j6 j/ b: g9 q: s
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Signature Date:
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Driver B: ?$ L) E* c1 e) f) W5 b
2 T% F: b" N: k' D- S$ kSignature Date:3 U$ T" D: a9 A; Z; ?
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Witness:
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Signature Date: |
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狗仔卡
发表于 2008-3-11 09:16
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