 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 Disclosure4 ~+ D9 _0 \2 A0 Y
Final Settlement
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CAR A:6 `# K2 P8 R8 N d' n
Year -! ]6 I7 g; @, W$ Z% _! U* N
Maker/Model -
$ `+ C. U1 j9 X. ~Serial (VIN) # -. \- t' l" H a/ E
Plate Number:! K }' _5 Q: s. k
Driver Name: (called driver A in this document)% Q# R% _. {, o- A
" X2 L! o+ [$ X7 A7 @% u) Q bCAR B:$ G: ~" Q Z3 N, x
Year -: w4 w$ m3 {4 R. `- K
Maker/Model –
% D4 [1 A2 ? {# z/ QSerial (VIN) # -- o; t% a/ i2 o" |4 ]
Plate Number:" m- l0 Q. ^# O" t! C; f" P! D
Driver Name: (called driver B in this document)
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5 M1 g& K4 I/ g7 r W2 x. W# ?In the afternoon of Nov. 7th, 2007, car B hit the back of car A.
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$ Q$ A& N+ S$ c( e, t' g' V: u! sThe driver B has paid
( I9 `: x& r3 ^, h( r4 ^1. Bumper repair: $7 n B% V# o( f L) n- y, ^
2. Other Compensation: $8 t- L; v+ ^; d# ^$ k2 _& ?
! Y" Q: [; k* T# f5 Sdriver 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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A. v1 E/ {& k; a6 N5 ?+ wDriver A:
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Signature Date:
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Driver B:
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Signature Date:0 U) I( P$ S2 K
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Witness:
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6 X. P ~! M1 v0 pSignature Date: |
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狗仔卡
发表于 2008-3-11 09:16
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