 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。3 O ?' K# h: b+ n y& j0 X1 h
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Settlement Disclosure
8 r2 ^ F% Z. Z1 `, hFinal Settlement
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, V: O4 M* c* M6 q# c, @ uCAR A:
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Plate Number:" r, r: V; a# [! |/ w5 q
Driver Name: (called driver A in this document)6 Q& I( r1 p" i( W) Z# P+ m# h7 [3 `
4 T" B0 r5 l8 E) ^: w8 YCAR B:
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Maker/Model –2 A( U$ F4 k! k1 r
Serial (VIN) # -% z8 j" b8 C4 O! i. r! p
Plate Number:( S3 `2 Z. Q3 e1 \9 c) d% y
Driver Name: (called driver B in this document)
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In the afternoon of Nov. 7th, 2007, car B hit the back of car A.% G- l" t7 `3 ~9 i% k3 R/ j
2 J& |" |1 x1 {9 mThe driver B has paid2 F3 [# [- @1 b6 d( Y
1. Bumper repair: $2 R, J8 j3 ]9 Q/ _( ?7 k5 W, n
2. Other Compensation: $) P Q+ M/ R ?) H5 R- i
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driver A and driver B agree to make a final and permanent settlement of this accident. Driver A has received the above amount of money. And Driver A agrees with this final settlement and is forever giving up the right to claim any responsibility of driver B or to proceed to judicial review by a court, concerning any result of this accident for damage of car A or injury of anyone in it.- H" f g) g% j, @
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Driver A:
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Signature Date:
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Driver B:% `, Q2 E3 s, ~. t! T) o
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Witness:
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/ N( H) K, S! \; V0 |4 i$ O* JSignature Date: |
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