 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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/ g) u; z7 R1 J$ t3 qSettlement Disclosure7 n% r5 e2 z6 K5 R+ z6 E
Final Settlement9 W8 r' ] D+ T+ l& X2 m( {3 W5 o& d5 M
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CAR A:* i" A& L9 x7 x3 z
Year -
3 A6 t$ S; L5 J; P: Q. P+ SMaker/Model -, L" k7 ?. x1 M( C
Serial (VIN) # -
1 L! N1 O+ |/ FPlate Number: |. ?6 \1 g- {" [* f
Driver Name: (called driver A in this document)
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- X% Y3 w3 T: _5 T [8 w4 HCAR B:
, s# ]- { r. t3 {0 x9 @7 i7 l1 BYear -# s% f* w7 s9 ?7 g3 f& z; ?
Maker/Model –
8 E% F# f; j% X' J) r3 ?Serial (VIN) # -
. j1 D9 o0 J0 ^+ V4 mPlate Number:% [2 L- X+ e2 c6 }% g! M3 l% }
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.# {2 o; R/ `& h( h9 T9 V, Q
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The driver B has paid0 }% k8 q$ ^; d/ V
1. Bumper repair: $
' G f+ C0 F% q1 y% z2. Other Compensation: $8 ~ }0 d! J& |
- z9 Y) x" Z" vdriver 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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" P" w& z) u: B# s) eDriver A:
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Signature Date:
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Driver B:: W/ z6 w+ ?! o; Q
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Signature Date:9 T: Z4 E x! Q. S" I1 \ h U
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! x4 d9 S, \: ^- ]" o: {Witness:
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3 R! `. {: d8 Y- m; E; MSignature Date: |
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