 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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Settlement Disclosure% _4 g- q" A/ `! z( k- o h
Final Settlement: V c( x4 P+ }$ n1 ]2 t! K5 Y
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Plate Number:* X" E1 I2 P+ g9 a7 w3 O
Driver Name: (called driver A in this document)2 r8 l$ z& T6 @& {3 m
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Serial (VIN) # -
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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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The driver B has paid
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2. 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.4 Q& A& s2 s: R, E+ ~1 f
( @ S6 m' k( F6 j. p4 [Driver A:6 z1 M5 d( |0 I. g
, \) F" |1 y% D8 c. O0 S: h7 b3 ASignature Date:
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Driver B: u- M8 S5 s- c b) x# S' u
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Signature Date:
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Witness:- c) n* A X; O: p# g
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