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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4 x7 M: |# ? n# M/ L5 oSettlement Disclosure8 x& h$ }7 h* W5 q/ U
Final Settlement
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/ x7 X' k2 G- `4 ACAR A:4 Y+ u" @+ O" R$ H) f7 E
Year -
3 C& T4 ~6 s2 O1 LMaker/Model -& }" u* C! s% a/ x
Serial (VIN) # -
% Z5 _2 Z5 m/ b* G3 W+ tPlate Number:
& F4 p: l" Y( y2 @6 Q' nDriver Name: (called driver A in this document)" y! v5 c% Z$ o3 J8 |& L
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CAR B:
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- a& q( e; D7 X6 _& h! L5 HSerial (VIN) # -( K4 p- n. d- D7 p+ V+ [* X
Plate Number:$ }; C9 v e" ^+ e' X# z
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.
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8 S- D) o4 |9 d6 cThe driver B has paid
7 X8 B+ h1 ^, R% L2 X5 f2 [1. Bumper repair: $
/ N0 J# R* @0 ^% I2. Other Compensation: $
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" F3 \+ L+ F1 k1 odriver 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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3 s+ O) a0 a, B/ }, E8 B- D/ KDriver A:
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Signature Date:
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# X% Z. }) p+ L2 k: XDriver B:. K- W0 O3 p' U# f+ W
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Signature Date:* `3 l1 |3 ?6 ^3 J4 }. L
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, I' N0 I# ^5 `7 B4 h3 ~& F1 C& U/ rWitness:
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+ W9 L* }* {) c8 l) n/ E. |2 hSignature Date: |
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