 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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2 x% }- U' M6 M) A: Q& USettlement Disclosure
R( Y9 j3 L( [% sFinal Settlement' c1 |+ D# F2 c, @. h2 t' h: [
2 j& W8 m7 H8 p V6 W7 C% O' CCAR A:6 c2 [% |. ~+ V0 R) C; }
Year -
6 V. ^5 \* _2 b8 A9 n1 _Maker/Model -
# f5 }; `4 H' a0 i2 s' rSerial (VIN) # -: P3 v& P! t1 k' w) e
Plate Number:/ t1 h; B) b( J8 }, \- `- Y1 o
Driver Name: (called driver A in this document)
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7 o8 \9 g. e2 C- t ?% w9 ^CAR B:
) y4 N! `5 u. T. v- MYear -1 ?1 \) [8 q+ g( l! \
Maker/Model –2 f# L1 a, _4 l) S( K# n! ]
Serial (VIN) # -3 ^. f! ]* T9 ]: G) v0 }$ U
Plate Number:
3 Q( U! `1 J% i( O# Z. rDriver Name: (called driver B in this document)" q' H0 K& u& J# n
, D% D0 ~$ y: O: g/ v/ F3 GIn the afternoon of Nov. 7th, 2007, car B hit the back of car A.7 P4 A0 U0 Q/ v) g; g3 C/ I
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The driver B has paid8 e* J# k. O$ [. U+ c* s
1. Bumper repair: $# ~8 F& ^9 }# s2 W3 J5 T! r
2. Other Compensation: $+ b4 n" c- \9 c. @
+ e! J/ [- w' j' I0 odriver A and driver B agree to make a final and permanent settlement of this accident. Driver A has received the above amount of money. And Driver A agrees with this final settlement and is forever giving up the right to claim any responsibility of driver B or to proceed to judicial review by a court, concerning any result of this accident for damage of car A or injury of anyone in it.
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) r4 o% ? q7 V% W: Q( c5 l( n1 JDriver A:
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Signature Date:
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, o! C& y/ n1 m1 o: B
Driver B:
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Signature Date:' y5 C2 u) Z, F" D* X& \; X
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, D! B$ J8 `- H$ iWitness:0 n' ~* S# @1 U1 Y
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Signature Date: |
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狗仔卡
发表于 2008-3-11 09:16
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