 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。4 ^) s: b% X8 J( S+ I! U
+ b6 K1 R1 b/ m+ v% J7 _2 E5 kSettlement Disclosure7 L3 ~, U# S2 S+ c: d
Final Settlement9 V' I# L8 Z- S( ]: {& j
) z- M. V1 j F |CAR A:1 ~4 C: Y9 }8 D H" B/ n2 U
Year -; ?1 r# X3 P5 I+ [" Y" O, E
Maker/Model -9 B3 i% ^8 u7 I3 u: M- e
Serial (VIN) # -" T# i/ m8 Z( o5 O+ V
Plate Number:
6 u. ^# r2 I2 x( W" w6 [2 _Driver Name: (called driver A in this document)! s- K% l: _0 Z# G% f2 V! y
4 i1 S* j O1 S6 [$ B# p& {% RCAR B:
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Maker/Model –
3 i& r. J& y$ z4 u9 A7 Y9 vSerial (VIN) # -3 W* H% n2 L) ~6 M4 ~9 L% h
Plate Number:7 _7 _+ p8 Y+ [/ O# Y
Driver Name: (called driver B in this document), a9 d8 J2 |% Z: E6 n( \* h# k! m
! G6 g/ l; s) M" A8 \, `In the afternoon of Nov. 7th, 2007, car B hit the back of car A.
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The driver B has paid
, y( K5 z+ L5 D0 L# O1. Bumper repair: $
/ {* v& \1 j4 ^/ n4 b2. Other Compensation: $
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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." M/ }3 g5 M5 |- d( ]6 K$ t. k1 l
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Driver A:
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Signature Date:4 u) B- y- I( o. W1 p/ c
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: w6 ~: C# f2 E3 m9 `2 L" F! N9 e9 uDriver B:
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Signature Date:/ {0 @0 W+ ]. q/ ?8 h
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9 ~. ]4 ~, f: |1 ~Witness:. \/ z5 e5 a" |* p& T3 V2 q. E
; A8 q' h! T. a- P& ASignature Date: |
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狗仔卡
发表于 2008-3-11 09:16
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