 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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' A6 F8 E z$ \$ f8 FSettlement Disclosure! T# I& ~6 F+ w% f( s4 y8 m
Final Settlement
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CAR A:, a* ~8 w9 f) b
Year -
5 i/ W1 n- h8 d" KMaker/Model -; N# P# O9 \5 @! P: i
Serial (VIN) # -
: P" W+ {" p. k" Q7 [! y9 HPlate Number:0 g1 ~% ~/ j9 w' E
Driver Name: (called driver A in this document)
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CAR B:
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Maker/Model –7 v: @# g/ K/ a/ `4 d, S
Serial (VIN) # -
' s$ L0 c7 q5 j* z3 x. j, oPlate Number:
5 l$ z; e% g' O3 X8 ?Driver Name: (called driver B in this document)
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In the afternoon of Nov. 7th, 2007, car B hit the back of car A.
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+ L# V- o8 X8 NThe driver B has paid: j/ r5 X' e, ? ]6 X* H
1. Bumper repair: $
: ]& M+ E3 |3 Z1 t7 x$ y* o2. Other Compensation: $0 o' V0 d* E, y
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driver A and driver B agree to make a final and permanent settlement of this accident. Driver A has received the above amount of money. And Driver A agrees with this final settlement and is forever giving up the right to claim any responsibility of driver B or to proceed to judicial review by a court, concerning any result of this accident for damage of car A or injury of anyone in it., ]' P2 q! B, p9 r0 w
" S# J. @/ I! f5 W) ADriver A:
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3 z; I) ^- Y) Q- L1 eSignature Date:
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Driver B:5 C; E+ Q3 m* b5 ^' j. D
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Signature Date:
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) b- P' ?& t+ U$ e# w& S0 }& hWitness:; q6 Q1 w8 b6 v- | X+ D! E j# N& @
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Signature Date: |
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发表于 2008-3-11 09:16
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