 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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9 [! X% I. f% t% w7 GSettlement Disclosure. J" Q7 |4 T' a- s
Final Settlement
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CAR A:; j0 I$ |, r6 p% Y; V. H) p
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Maker/Model -
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/ z! |/ |7 a' k0 d& g& V# v% s, ePlate Number:: S. \! [% z/ I8 f9 \1 r0 v
Driver Name: (called driver A in this document)) b5 j6 H$ |- R7 g1 ]9 z7 d
; O& h0 e' _, a# V2 O1 _: OCAR B:2 p6 h+ L0 w* G* W
Year -0 C1 ?( f, o5 S! H
Maker/Model –
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Plate Number:6 k k* O) {) F: s9 d/ U
Driver Name: (called driver B in this document)6 p3 ~% q% n, ]- F3 k
; Y/ W2 x$ o8 F4 D! V% E" w* yIn the afternoon of Nov. 7th, 2007, car B hit the back of car A.$ N+ k. _6 f( F
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The driver B has paid. c+ U( m% K, S1 h* M* ~
1. Bumper repair: $) {0 f) P& j0 N9 D7 n# n ^
2. Other Compensation: $. x! T& b6 O9 R
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driver A and driver B agree to make a final and permanent settlement of this accident. Driver A has received the above amount of money. And Driver A agrees with this final settlement and is forever giving up the right to claim any responsibility of driver B or to proceed to judicial review by a court, concerning any result of this accident for damage of car A or injury of anyone in it.! U( a/ L8 _) l1 r9 q
8 W8 Q* [- k0 v8 T( RDriver A:" N8 l! z7 S/ R& L
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Signature Date:+ U- d }# Q7 ~2 p7 M9 n
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Driver B:
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Signature Date:) H% ~3 q2 k) ]+ L
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! Y1 E( G: x7 s$ L7 K/ D* w# W2 B; qWitness:0 G' M& q. ?* ~" e
7 d' V- }9 ^& E5 B/ USignature Date: |
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