 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。4 |; z* Q/ b, R& D0 N" m# h
0 R+ q; @- u5 h( HSettlement Disclosure
* [ E, t: R% V; T! OFinal Settlement4 J. `! t1 M+ L, M1 N0 ]- f0 A }
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CAR A:, Y# |+ b% x' D( S# ^ [# o0 u! s% B
Year -
) S) d, u" y4 V: {6 i/ AMaker/Model -
& ?. Q/ q2 L3 r# n$ F+ PSerial (VIN) # -
+ O& t; {* `0 C9 GPlate Number:
0 S4 L; D3 J5 D: I+ ]# D, ^Driver Name: (called driver A in this document)* D. W) N2 W c
) k% s Q9 }4 ?" E! @7 I& w5 dCAR B:7 z; a5 }( u2 l3 }' M! M3 ?. @
Year -
5 z1 P* q6 e9 e0 ]( d% v2 l6 B& \Maker/Model –
( F3 T$ y/ K* O- G* m3 tSerial (VIN) # -/ M0 b' T* e9 d& E9 G
Plate Number:
2 l3 X/ Q+ G V% [ B7 _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.% y W% z& s1 f, x% T4 k' ^4 }& X
, \( P$ J% g* h$ `5 _The driver B has paid
( ~% o; b8 h+ p. @/ x; I+ k7 `1. Bumper repair: $ A' q: D) f2 v
2. Other Compensation: $ U: `! u, W( m7 L+ K9 y
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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.8 i- j C( R0 S7 V5 B$ I& m# u
9 |' I# A6 h, L$ _( Z6 u8 H2 hDriver A:6 r' W: l" ?6 W" J6 ]% E) h
: L3 x: B O5 sSignature Date:
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0 D S8 E* P% h3 p+ b6 ^9 Z& n$ r$ D( E* WDriver B:
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Signature Date:4 U( a: i. i# s& Q3 F; x
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Witness:$ M% A+ j; W v* |/ e$ g/ A
: x; l9 n# J; q" r4 aSignature Date: |
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