 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。( ?! a' r8 f# w) s
* [* x$ m) Z8 Q8 @Settlement Disclosure
. _1 r) T/ ]4 k. c& XFinal Settlement& H7 Y4 ~& g4 i+ e2 ^# S9 b; O- _
' X. z$ u3 u0 Z4 |CAR A:& x1 ^. Q/ R9 J2 Z% S. |; d
Year -7 b" E7 ?) S1 j
Maker/Model -2 D: Q% R. d: @( Q4 j- L8 j
Serial (VIN) # -( b$ B. q: P! u* `
Plate Number:
5 m9 ]$ q$ `$ n2 O6 ~/ O) oDriver Name: (called driver A in this document)
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CAR B:1 x. P5 B# B( [) T# Z" l3 j
Year -2 _% i" a- W. w" m2 j
Maker/Model –8 j( ]' e; I' v( J- V; J" S
Serial (VIN) # -
9 i/ m9 r5 }2 S; i# ]4 jPlate Number:& U, n' @- R1 G# G& j, ~* N: n
Driver Name: (called driver B in this document): w% N% x: T5 F* ]/ {7 G; k$ t
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In the afternoon of Nov. 7th, 2007, car B hit the back of car A.
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+ t1 \/ F$ P2 `, w$ ^The driver B has paid+ ^8 G* M! q4 Z" S
1. Bumper repair: $
& l! A( m1 G: W' m" w8 U) l& v2. 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.* q& d; H( O( p+ _" J% h4 o
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Driver A:6 H; z, m9 w5 K0 E g6 H j
4 J' f+ Q8 V5 j2 Y8 T: ^) k' J" M, sSignature Date:
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- n' K( O, _, NDriver B:& Z8 ?3 z% h! \6 j
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Signature Date:. Z9 I. s4 g* w6 h. a
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A1 Z% _2 X" Q) y7 E$ oWitness:
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1 v; l4 A; v4 L; MSignature Date: |
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