 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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0 R6 A0 B5 P6 kSettlement Disclosure: H7 e! V2 q0 F/ U
Final Settlement" d: C" H9 {0 m2 H L6 I( ~
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CAR A:# e9 S& H. J, M/ J
Year -- ?5 a( ~' [( L
Maker/Model -0 C, E% G" ]9 w$ i% L9 V3 v5 K
Serial (VIN) # -
1 s5 o5 r9 z6 ~ H6 cPlate Number:* w, z# t4 c* p* k( Y7 z
Driver Name: (called driver A in this document)8 J. d( M9 T4 W. q
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CAR B:
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Maker/Model –! S- f s# S8 y1 ~3 p* ~8 l3 N
Serial (VIN) # -$ H; N6 _& T5 ?* n' ]; [; ]
Plate Number:
' m! F- m3 l! y" {' a) l4 p5 IDriver Name: (called driver B in this document). l4 l* x+ o* J# a9 c
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In the afternoon of Nov. 7th, 2007, car B hit the back of car A.7 O" Z8 I, f% m
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The driver B has paid @0 f0 a" E9 V) S. x0 |* }% K
1. Bumper repair: $
$ b: S8 g/ t4 o5 N& W2. Other Compensation: $" z( I2 E( D" Z! C6 G2 {, h
* [8 ?2 R6 H4 N8 adriver A and driver B agree to make a final and permanent settlement of this accident. Driver A has received the above amount of money. And Driver A agrees with this final settlement and is forever giving up the right to claim any responsibility of driver B or to proceed to judicial review by a court, concerning any result of this accident for damage of car A or injury of anyone in it.
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3 L: k1 U2 C) D3 w+ ^Driver A:* i* _$ I2 c4 a* G8 o* ?9 N
( R. @! D/ [6 |8 zSignature Date:4 }+ e+ R9 e' \' y
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3 v# T n+ P& g$ A" ^0 _* b! DDriver B:9 t( _/ g2 ?; L% t9 Q
* H/ B9 Y- o( M% `4 G0 Z0 gSignature Date:
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Witness:4 b. X* l- E/ Q1 p( ^! h* C4 y
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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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