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这里有一份
自己酌情改改就可以了。; d3 A8 ~) ^% A
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Settlement Disclosure' `% N5 p; L* }& w
Final Settlement; f; V3 _0 ~& W; h! f; c5 v9 z
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CAR A:* a. A7 Y% Z4 B: U, v( e
Year -$ |) F; P! P9 p+ \' |* C3 R
Maker/Model -( Q1 R, ~# S) |! m0 U
Serial (VIN) # -
1 j- ]; W+ N/ |; BPlate Number:
, @* B/ V0 a: F& F; v# ODriver Name: (called driver A in this document)! M/ \' X! y5 l, I4 v6 U
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CAR B:
: t6 W K$ V4 d/ @; H9 j3 tYear -
6 c# R5 z8 A$ L8 G# P4 TMaker/Model –2 ~+ }% Y$ } }8 I" b8 z( O
Serial (VIN) # -
) I7 \9 i/ s$ Q7 u' o" ePlate Number:" C Y* v' l- Y! ? z( ^* [
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.3 x$ i" G. n5 S, t$ M/ L
' M" s5 K/ N. i6 s7 k; [The driver B has paid P1 ]) A$ ~3 o/ l* ^. W; N- G
1. Bumper repair: $! i) U+ {2 c: J7 W
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.
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Driver A:
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Signature Date:0 s1 Z/ O& Q' w2 N8 g, w9 F
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Driver B:
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Signature Date:
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; p, T+ `" g" @. Z; a+ {7 SWitness:
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. Q* l( o% D# o9 qSignature Date: |
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狗仔卡
发表于 2008-3-11 09:16
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