 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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Settlement Disclosure% G6 B: H& E5 Y* ^
Final Settlement
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5 Q) u7 k! F1 iCAR A:0 ^8 @+ Y2 J, s9 T9 ]) o3 C
Year -
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Serial (VIN) # -$ z0 X2 G3 [ }7 D% f5 K
Plate Number:
7 Z7 S2 X5 L1 G, @Driver Name: (called driver A in this document)
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# X* ~' H3 z+ {6 D0 j$ VCAR B:
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Plate Number:# P' A0 u/ p5 y5 U+ J
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.
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The driver B has paid+ Z' A7 C; m8 ?8 ]! @6 {! T" Z
1. Bumper repair: $6 R+ ~) j# L$ s+ i- }
2. 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.( U7 n" @" @( t( O+ t! W$ U
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Driver A:4 m9 U0 F. b0 |. R4 q
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Signature Date:, |) s, |0 @/ e& P+ o0 [& m" _+ C9 i
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Driver B:) N/ Q% U. U0 ^, S- a, m8 W9 ]
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Signature Date:
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Witness:
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7 x! [* @7 F, G& o6 Q5 nSignature Date: |
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狗仔卡
发表于 2008-3-11 09:16
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