 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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: R9 t' P( T, B+ k9 g6 JSettlement Disclosure( T7 C, F" t$ _2 R* v) S
Final Settlement
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5 i6 m+ u k5 K' x/ @8 N" ECAR A:8 W0 B4 n$ J1 g- h2 }
Year -) a" @& f; G6 @
Maker/Model -* ~' k6 x/ q' y7 B
Serial (VIN) # -9 Z7 h2 a8 v! K9 V
Plate Number:6 q0 N2 F" {) f7 {, r" }
Driver Name: (called driver A in this document), J5 b9 v1 L5 I
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CAR B: [4 K# A& z- x5 n. V4 f, l! T
Year -$ F, j' E5 j& T$ ~* e; p7 g
Maker/Model –1 ?& A3 a$ L6 d
Serial (VIN) # -
. L- M6 J6 f4 APlate Number:
; N$ q- u2 M" e0 N. s2 aDriver Name: (called driver B in this document)
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3 \7 a4 Q$ R1 c& Y+ H8 i/ r0 nIn the afternoon of Nov. 7th, 2007, car B hit the back of car A.& Y, r1 \8 M1 a, ~4 d- ?4 K! @& v
+ G0 P2 W+ R& x( _/ Y5 T; [) \; VThe driver B has paid
& R8 q' T" u0 E1. Bumper repair: $# W$ f* ]* g2 `# u
2. Other Compensation: $
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* O2 W. B' M+ ^4 j+ o1 z0 Ldriver 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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- F# s" \1 Y8 a6 L- t' G4 o8 v2 [Driver A:' |% N3 G6 D3 \0 p
* D% I V5 c- g( ~Signature Date:
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# l: l# W4 [- S- _4 XDriver B:
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" c; }# V$ |" z) O! Y5 p) uSignature Date:
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Signature Date: |
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