 鲜花( 3)  鸡蛋( 0)
|
这里有一份
自己酌情改改就可以了。) v7 w5 U, i: [4 L0 W, L
8 P1 g5 B+ i. H a) [6 \7 SSettlement Disclosure6 C8 o6 c$ Q+ o% p
Final Settlement! v5 }: V. L# B+ w7 O
) L2 {2 v9 o0 O9 s2 L* MCAR A:9 r, a: ~' C) T, i. p
Year -; U5 P$ e t$ _( M' u# Q
Maker/Model -/ O. f+ Q8 s" s; S% v: q1 {
Serial (VIN) # -
/ d M3 Q9 \( L/ q! M3 {& TPlate Number:
1 E) J$ N2 k" ~Driver Name: (called driver A in this document)3 \" ~9 c' y& W
/ Q& { G+ ]& _0 OCAR B:
) S% R1 j! x/ f8 A6 PYear -
H( m7 A( Z$ @4 `Maker/Model –
' c5 c6 i: l5 k- s7 OSerial (VIN) # -
* z- ]5 Z& |* Y. e' t6 gPlate Number:
2 _/ P2 @$ B, b; K ~; D8 FDriver Name: (called driver B in this document)
+ ]. w3 v' J0 c: t8 x$ Y6 _3 t1 \
9 B8 K* _# ]% g4 |9 J& @3 p/ IIn the afternoon of Nov. 7th, 2007, car B hit the back of car A.- K+ W! X5 U4 i- G1 }1 p
: B2 [% q1 ]7 E" z! r! ~: x& P$ T
The driver B has paid
3 u/ B5 q+ M2 L! N" n( r1. Bumper repair: $
" `; z# e; `9 A' y9 G8 z2. Other Compensation: $
9 y6 M/ i: i; G* K! \- ~) M q$ O7 y/ \: u4 a
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.! J* A6 |$ D1 \5 Y# _$ w
% S1 D* S) H# ` o
Driver A:
" t8 Z( x' g# o2 @5 Q' a& U7 r% \5 g4 Z4 q p' k
Signature Date:. k0 N) J, P6 U- }; b
# d, M, n9 ^& O( B! k5 O& W3 U& ^/ y+ [
Driver B:
5 w; |8 s5 R$ o7 z6 i3 p0 l+ ^9 s' T
Signature Date:
. U9 w3 E* `1 v: E. ]% t* E- v( l
+ K- N9 z! J, B& e' y. g; N0 k
8 Y% p) D/ N9 O3 {4 @- g$ \Witness:
# E3 d$ l/ P$ ]9 s- p- J7 L/ Y
6 K# _* ^; s6 M) o5 k! LSignature 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
