 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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5 M0 s3 K1 o( Y0 o1 k8 Q- w& USettlement Disclosure; k+ Q5 M) w0 h; ]3 _
Final Settlement
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CAR A:
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Serial (VIN) # -
' {# O4 T9 Z0 R" w( fPlate Number:
) b* B t$ b* BDriver Name: (called driver A in this document)4 X* f3 Y- n8 V4 n$ ~5 ~& K$ Z
C0 Y' M4 S) |& t( U: Y0 @' c [CAR B:
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Maker/Model –. B( Z$ r) O) ^) Y
Serial (VIN) # -
- u, Q0 S, h- A( \Plate Number:
- h, K% b: D7 I- _5 @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.7 j. }+ H$ F9 G! Z
- @- U2 W- @9 _/ z* IThe driver B has paid" \" ` Y$ `; P; L3 J- H) Q+ U' b
1. Bumper repair: $
6 m, \8 n7 r' C* [5 h) y. s ^# w2. Other Compensation: $! x8 `( a# _/ c, W
9 o k7 U9 ^0 f& w( H E/ }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." q7 X, y6 e4 J1 A
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Driver A:
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Driver B:
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Signature Date:
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Witness:
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Signature Date: |
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