 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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+ N9 K% m7 B* D, ?9 d* iSettlement Disclosure
4 U) ^7 S( c+ Q/ ^4 }4 tFinal Settlement
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6 E; G7 }, i7 U1 t8 N9 tCAR A:
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5 ]# g- t7 d" ]Maker/Model -5 p; Z" O) f$ \ n m3 f( ^+ V
Serial (VIN) # -
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Driver Name: (called driver A in this document)3 L3 m% ]6 |& v8 x2 B
- {7 C2 N: q, L. Z+ ECAR B:* h: i7 x* s, v5 x7 r
Year -* |5 ~( } n7 R: G0 F
Maker/Model –' t; H7 }& ~" r9 X4 H
Serial (VIN) # -
) `, ]& G8 O; k, i4 ? EPlate Number:3 [; I7 k" g# _& x* W5 F! f
Driver Name: (called driver B in this document)
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+ l+ [: x- H5 p4 R/ @In the afternoon of Nov. 7th, 2007, car B hit the back of car A." d& s! r6 o2 U% a5 Y) x9 O% G
) C& M9 U4 C* `' x- W$ }The driver B has paid n9 N* d' _+ J; L. H1 a2 G
1. Bumper repair: $" D6 V% M5 u1 Q# a
2. Other Compensation: $
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. ~9 S0 ^& o0 h p4 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.' |& i) E- i" c" o- Y7 N/ }
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Driver A:
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; O& G, z5 z# }- b' KSignature Date:4 {2 @- M7 F. d) w$ |
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6 J4 \# C' U6 \ p: k; [, }Driver B:0 L2 I' {8 \% W/ _+ r
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Signature Date:
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0 {$ y5 C$ _. I: ]* G6 q; KWitness:/ K- Z% F' B& }/ ~" _5 V4 D$ ]
, i, H% U: }1 R8 rSignature Date: |
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狗仔卡
发表于 2008-3-11 09:16
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