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这里有一份
自己酌情改改就可以了。' ^4 {/ h+ v3 O" a4 E# ~# J' y
) \' ]/ z& S0 TSettlement Disclosure& G/ Y. I# O1 t# l5 q
Final Settlement
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CAR A:
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( Z( s6 _6 t) P$ j) ]& h5 z0 o* zPlate Number:9 F+ v* a3 J6 W Y
Driver Name: (called driver A in this document)
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CAR B:
q+ M$ I3 }; B' ~; MYear -+ C$ e7 y% q; {% t$ b. o
Maker/Model –
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2 s8 O$ d+ A8 L" L( U% N- PPlate Number:5 R- M! v( X& q. _, {
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., T2 C0 \+ L- ^3 P& Y
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The driver B has paid
) A- a6 }0 r9 H1. Bumper repair: $
# U2 \0 N% y- l( x% Z$ W# j# I2. Other Compensation: $
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$ S7 t& j* V1 ?9 m/ M5 ^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:% U2 v' B0 I" I: j! R- _; L. ?* V
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Signature Date:' y% T, `9 g3 D, g
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Driver B:
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1 _& b! t$ w" V! @5 eSignature Date:3 T. w( z2 |6 d' U& M7 H! a( z
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) h8 Y- A" r s8 xWitness:
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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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