 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。% Y" z7 y$ V5 |- d9 K! \, c
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Settlement Disclosure/ V- F' ~# e$ z, T+ f: a
Final Settlement' u2 e$ O! Q/ \0 R
5 k1 e4 i! i4 d: {! Y: ZCAR A:5 h" Y5 E- h* Q2 T
Year -$ W! ]1 s5 H7 S4 d* Z7 [
Maker/Model -9 {6 Y' v a: h
Serial (VIN) # - Z5 B" \* D- M+ I1 i. K
Plate Number:4 Z w3 k2 @$ r& W. V4 p
Driver Name: (called driver A in this document)8 [( J- l) Y6 C
6 i! U9 P) Q6 q5 ^ a& r( j6 K4 i0 ?5 lCAR B:0 h+ {3 L- o$ _( [' A$ J0 M
Year -0 N7 k- E8 y$ I
Maker/Model –; U& e- R* }) u6 p8 j) m
Serial (VIN) # -
: H7 l8 D: i& rPlate Number:
; f4 I' p& a8 j% jDriver Name: (called driver B in this document)1 }* `8 `; q. Q V% s6 w5 L" r
* y( A* V' w9 h9 X# E9 [In the afternoon of Nov. 7th, 2007, car B hit the back of car A.
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The driver B has paid
2 r! l% g3 Y$ e. E9 T, U( d1. Bumper repair: $, K$ E3 ]* E U7 t
2. Other Compensation: $7 b9 z) n2 @+ Y
8 C$ K) ~) D7 r4 z+ Ydriver 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.
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Driver A:
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& C$ C: \6 P' c- m; p2 J6 ySignature Date:; X4 k. ~% s+ U& a
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4 i) S: U+ F! l! B$ x8 G {9 `Driver B:
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, B! X0 H. {* Q3 m! Y: E4 kSignature Date:5 O! r: y: y- |/ B* l* y
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Witness:: c$ p# @% b7 A7 _: N$ c% g2 r b
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Signature Date: |
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