 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。/ d8 n B; z$ c- H5 e- @) ~
2 p7 R. z# R2 l" G7 k6 HSettlement Disclosure
; x6 ^# t" r( ]Final Settlement" i2 j t: q0 B( ^/ ~$ ]5 I. B
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CAR A:. B/ U9 \5 p# |0 h8 G
Year -! @4 Y, X+ n8 M5 L" H
Maker/Model -
: \0 {5 V- C2 p, O) W5 BSerial (VIN) # -
- T5 M3 G9 q7 ~% P5 U PPlate Number:+ z# u& F z1 y# J& |1 e3 r
Driver Name: (called driver A in this document)2 @0 c% U( F, b( Y* R d
9 \* U9 z# |8 @5 PCAR B:+ S; I, J' y- a
Year -% p& M8 b B0 G
Maker/Model –7 D$ Y7 {. R, x, ?, m
Serial (VIN) # -
: C) [9 Q* `) iPlate Number:6 X& {, w T5 `) n( ~% k
Driver Name: (called driver B in this document)
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& x- X& C- e) `! N' vIn the afternoon of Nov. 7th, 2007, car B hit the back of car A.- R# ^' [% K# W4 [3 a
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The driver B has paid
3 [. k7 O, U5 n0 J6 j. L1. Bumper repair: $3 A$ k5 d7 v. l, U' z" W; g( e. @
2. Other Compensation: $, o0 \5 C& S- y
! r3 b9 z% r. p& n6 b6 Mdriver A and driver B agree to make a final and permanent settlement of this accident. Driver A has received the above amount of money. And Driver A agrees with this final settlement and is forever giving up the right to claim any responsibility of driver B or to proceed to judicial review by a court, concerning any result of this accident for damage of car A or injury of anyone in it.2 E0 d9 h5 g& I
, P _: y4 e8 o& m( XDriver A:
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6 {9 x+ q }. K i0 OSignature Date:. Q* h# a7 L( F; E: z7 w7 g
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2 |: q, r; g) E# |! R9 ^Driver B:
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Signature Date:; Y6 H. C8 K$ y8 n: B: s& ~
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* T' }" i* W" g: |) `" L& `Witness:& u! f8 V) ` M- v- |6 `, T
6 f* M' s7 d/ [( E8 KSignature Date: |
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