 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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, t/ c4 Z- l9 b8 bSettlement Disclosure9 h" u2 K0 |+ B! T: T" h
Final Settlement
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$ t3 A9 y3 u. a; L1 a7 N/ NCAR A:. r+ J/ w! x9 k. x6 d
Year -
+ l8 `8 X7 K6 K9 ^- j; s; J% HMaker/Model -, A4 g& J" @7 u$ J! d1 Y
Serial (VIN) # -
' I3 P9 g( Q2 L: x$ S/ F3 C2 jPlate Number:+ x. W: S! {0 R, M: }
Driver Name: (called driver A in this document)
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CAR B:/ x$ ^3 c. S6 S* P% @0 M# Q( `% P
Year -
. s' w0 z' l0 S p$ m- pMaker/Model –' e V0 z8 Z" v
Serial (VIN) # -, R8 z- [: O- W
Plate Number:, w, R5 r3 D- W) @6 n
Driver Name: (called driver B in this document)
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2 c9 U+ D* Y: mIn the afternoon of Nov. 7th, 2007, car B hit the back of car A.
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The driver B has paid
' R- d8 y+ p/ g) K7 l1. Bumper repair: $' g8 P* B- u/ k, \9 j8 ~ [
2. Other Compensation: $6 k9 C- K" k7 i# h: g
( [ c! h; I) u- V, c: `3 z- idriver A and driver B agree to make a final and permanent settlement of this accident. Driver A has received the above amount of money. And Driver A agrees with this final settlement and is forever giving up the right to claim any responsibility of driver B or to proceed to judicial review by a court, concerning any result of this accident for damage of car A or injury of anyone in it. ]7 O# F9 @" t
9 Y" a( G F$ F* C4 ODriver A:
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Signature Date:
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/ L& b* y5 q6 X# _Driver B:
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% h4 X- g5 @ i8 o' f- O9 v& bSignature Date:: T- C6 J0 {9 ]9 v
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. r2 |- G5 I4 H/ m9 |/ p: ]Witness:+ P' H, ~' D2 b6 m
$ Y! W9 b, E' R5 z: DSignature Date: |
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狗仔卡
发表于 2008-3-11 09:16
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