 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。' y5 T! i- n Q
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Settlement Disclosure
0 e8 h5 `" U; @5 @5 fFinal Settlement
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% ~: N# m( q6 v$ A# }! @+ _* @4 ?CAR A:
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Maker/Model -
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Plate Number:5 Q R" v; u* U: q
Driver Name: (called driver A in this document)
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: V b0 h. d/ R( a( ?" |CAR B:
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4 T! g' O' a, k; Q) ^5 H2 UMaker/Model –
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7 W* O( |6 Z5 {+ @2 M9 kPlate Number:( R/ U3 b' Q# \4 V; K
Driver Name: (called driver B in this document) [+ d& D, T9 v# @0 s- C
4 c0 s H( j' W# [# T4 ~6 B2 c! oIn the afternoon of Nov. 7th, 2007, car B hit the back of car A./ |; h! F2 t q6 E
3 c0 X% a% G/ [! v) Y& R8 zThe driver B has paid
. {% `7 A* I" G$ u1 m6 a8 _1 i1. Bumper repair: $; S$ {! o5 Z6 V
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.: ]4 ^5 N, d4 Q# j _1 ], W! x
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Driver A:
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Signature Date:7 `$ K+ F! E4 W+ P
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Driver B:
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Signature Date:
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Witness:
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Signature Date: |
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