% I# D- g. p. ]! w8 M3 OThis is the full and final payment for the incident between us, XX and XXX at (车祸地点)on (发生车祸的具体时间,哪年哪月那日). The agreed sum of $(你付给对方的钱数)cash for damaged. There is no other claim through insurance or personal for this accident. This is the full and final payment.9 e F: N2 d. }4 R
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$ g) _ Z5 A: a" D * C) ]! \; c D$ o0 E& |# pSignature of 3 U: a" @1 A2 p- c N' c4 x# R(让对方签名) 8 G$ p! |# \& m3 S) M& E一式两份,对方留一份,然后自己留一份