 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 Disclosure7 ?3 P' \& M/ p# x( m6 \
Final Settlement, o! M1 E9 p# L5 Z3 T! j
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Maker/Model -' @4 J2 v" e7 \& a4 R4 H
Serial (VIN) # -2 F; x1 V, |0 ?9 f
Plate Number:
) V% F9 [( T7 k, E0 a ~Driver Name: (called driver A in this document) f$ P( ~( J, q/ m
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CAR B:
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Maker/Model –0 m8 E. b6 J: \4 e: T# J
Serial (VIN) # -
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Driver Name: (called driver B in this document)* u+ h; f! C9 q
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In the afternoon of Nov. 7th, 2007, car B hit the back of car A.
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The driver B has paid- T# j& E% k2 A2 F9 x1 o" S
1. Bumper repair: $/ S/ T) _& y) x0 I
2. Other Compensation: $4 ^0 b/ }% [; {8 S1 U& A" @
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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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; _+ f4 p+ |' A; m0 o4 V! s( P1 aDriver A:
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Signature Date:1 P9 P- V8 D R4 A; z# q/ Q; \ E* o
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Driver B:4 v' d5 l% a4 b& D( T7 x. T: k% d& P& {
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Signature Date:0 }2 c- H! E. @7 t
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Witness:
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Signature Date: |
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