 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。0 \9 x4 T, t1 A6 q1 s( w, g7 O
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Settlement Disclosure; Y' z4 g6 Q* D* j7 N4 ?3 H
Final Settlement$ {0 G ^: U( I5 |) O
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CAR A:: I% Q1 {$ T5 n9 K2 `/ F
Year -
- D2 P( g; _5 G5 F! g4 y1 aMaker/Model -
% P+ h5 y) E. M5 ]- H" A! ySerial (VIN) # -+ U8 p. w$ i* D1 n1 r/ d7 m
Plate Number:
( u) f0 o* m. o0 ?7 uDriver Name: (called driver A in this document)5 _+ t; T" q! P* G* ?8 j
8 e( s2 C2 `+ M: ECAR B:" K' `! B5 @$ ?: q; w! I
Year -: k i# o; a0 n/ w/ y4 D& [. W
Maker/Model –3 M X' L- T- y9 e, N3 P4 `& N1 r
Serial (VIN) # -
6 D3 s" ~' {0 E+ T1 D( f, {Plate Number:
7 F0 Z+ v$ Y( w$ c# k; QDriver Name: (called driver B in this document)+ s, P! g+ T* Q O( N$ ]1 C! s
6 g4 b3 w8 c) K( S( zIn the afternoon of Nov. 7th, 2007, car B hit the back of car A.; M8 _7 h$ [% p' }" i$ {9 j" t
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The driver B has paid
! a0 |0 y# M/ ^2 F1. Bumper repair: $% E# s: ]& i$ h& q: e8 \* V
2. Other Compensation: $
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g. u9 c) p% Z5 [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.6 C9 Q' H' }: Z3 S
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Driver A:* p* U% U& C7 R% [" q8 x+ y
- _5 a" ?9 e1 O4 DSignature Date:: |! q- K# c! h$ I" [) ^! G6 `3 e
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Driver B:
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Signature Date:! m2 O7 I- f- @
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Witness:* J- k0 x0 u5 P; W' m* H( w
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Signature Date: |
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