 鲜花( 3)  鸡蛋( 0)
|
这里有一份
自己酌情改改就可以了。
4 s7 T" V5 {; ]: @& K! A5 U
1 F/ A3 A& c2 nSettlement Disclosure+ H* P" R+ ~1 ]
Final Settlement5 Q1 }, g B) }. w) K5 [ J
8 W' V6 [* f6 A6 W) p$ D$ ECAR A:( O) I5 i: x( U8 z( {- K) q
Year -4 M* N9 U. O/ u3 s/ L+ B
Maker/Model -
* W- C* t8 Y( P& D3 I: YSerial (VIN) # -& J4 Y# w4 w' P+ { L1 v
Plate Number:/ q5 B+ e T# c5 ]2 ^
Driver Name: (called driver A in this document)' H. b, s. u( C0 }, F# B
8 m9 _; b, e0 w# Q
CAR B:
' z8 y$ g2 ~7 W5 N( }Year -
3 Z9 Z, O) b. w7 F X2 i# UMaker/Model –1 ~9 m1 v! `7 s) |$ s0 S/ O6 k: N% H
Serial (VIN) # -$ w0 F1 A8 _: V
Plate Number:
$ ]) K" Y( r; ^& }# u, `0 M4 a8 VDriver Name: (called driver B in this document)9 I, b& e2 b6 s, D K. T. o
, o$ M/ c- x, g6 n0 rIn the afternoon of Nov. 7th, 2007, car B hit the back of car A.
0 o% |8 C& V$ o: w! T& z; F0 |* H, V5 H8 }3 g, c6 Q: N
The driver B has paid
# \9 c: L" F2 b1. Bumper repair: $, e, H1 z9 N+ J1 S& \
2. Other Compensation: $
0 C$ X$ z0 q; Y7 m8 K# E6 b$ f
6 n/ q* h2 K" r6 \0 R( y ~8 F/ \, Ndriver 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.
% c, D6 O( I8 u
n; u$ x3 q- v# C) }0 |' RDriver A:
( d2 {+ J A4 O
# M0 i+ g+ ]8 r {! i6 q0 u$ k7 x3 ISignature Date:. E" n) U% k- [+ ^, `9 h0 D$ X; ^
6 Y6 ]* H7 ~' x2 F+ K5 b
3 M* ^* Z& y$ ^$ O9 J! ^, q
Driver B:7 S1 b, w$ _/ E5 ?2 ~# `
7 O( w, |% ?" z0 o5 D( U* w7 M rSignature Date:
" v* |, [* c1 K% d
0 c5 A+ b1 J) O
' T1 k5 c8 d9 D6 c5 J* }Witness:. H0 ^9 t0 S1 X! D+ u
- Y5 \8 f1 D4 H- c2 J- p# a
Signature Date: |
|
狗仔卡
发表于 2008-3-11 09:16
提升卡
置顶卡
沉默卡
喧嚣卡
变色卡
显身卡
楼主
