 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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, c! g7 y, l3 z) @" tSettlement Disclosure( F# c% e$ x/ n9 f Z0 Z, l2 D
Final Settlement% T% F- \6 j$ ]' [) A
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CAR A:
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Maker/Model -
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Plate Number:. S6 ^) F Y' J0 L, P2 J/ F
Driver Name: (called driver A in this document): Z- O' O4 p6 Y9 a5 ]
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CAR B:
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Maker/Model –( l J( o8 t6 f r8 \1 q- {1 a
Serial (VIN) # -1 q3 E- u7 O0 U$ D8 R& C7 ]
Plate Number:
6 T& s8 Z4 J" u$ K$ b* l& HDriver Name: (called driver B in this document): H( C4 ]2 z4 R6 O* u
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In the afternoon of Nov. 7th, 2007, car B hit the back of car A.
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$ q8 v- {, U7 f4 MThe driver B has paid W8 B% r$ x5 G/ |7 {
1. Bumper repair: $
2 j5 l/ ]- a# D$ w5 I* K2. Other Compensation: $* _. y, y$ w$ _) E4 M
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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.7 {& [/ I# ?# Y# f
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Driver A:; ^+ j) _) u9 L
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Signature Date:' r2 N% L7 ^, v, d H
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Driver B:1 E0 Z0 y5 j( ?+ K. Y# o
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Signature Date:- J7 p8 X4 J4 w
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Witness:: W( \! }+ \! C5 {0 N9 H
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Signature Date: |
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