 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。% U1 `+ r2 J" r; L) {0 O: X
+ [0 `( ~0 l1 NSettlement Disclosure9 E: H, N9 f& [" e' G
Final Settlement, G) _. E9 P3 r6 }% S
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9 Y1 D& v' o! j% d" T5 ^Maker/Model -/ |2 f0 k& ?$ S) t+ C' X N6 k# N$ l
Serial (VIN) # -& X* i8 U! _/ D9 P- m) a7 P) i! }; l0 b; V
Plate Number:0 z: Z" Z( G2 p# B0 g
Driver Name: (called driver A in this document)
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CAR B:
9 J+ N; ~. ]: J( [) w/ a Z$ SYear -
2 l$ c; `3 u b9 ?6 eMaker/Model –8 ]/ P8 ~3 V9 T$ y: H4 I# R* s8 Y- t
Serial (VIN) # -
; l) a: B. `" K, B& A3 PPlate Number:
6 G+ M p6 y1 |2 I6 yDriver Name: (called driver B in this document)" ?; _2 j1 k, h$ S( t6 R F$ j
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In the afternoon of Nov. 7th, 2007, car B hit the back of car A.
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. H: `/ j1 f+ D: ?& o! _The driver B has paid
( E+ r6 o$ {8 \/ m$ f1. Bumper repair: $
8 A+ C( [, L6 b" g2. Other Compensation: $7 L1 P: G/ @. [6 E
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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 V9 N, q8 e( S A
8 l1 V& C, w" A1 sDriver A:) Y* k7 J4 y* M# d4 i5 a: \
$ V! K! y* z! g. o4 vSignature Date:
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Driver B:
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$ b2 B- d. V$ f4 VSignature Date:1 e9 Y \# S) e7 |5 [) b) h
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Witness:+ Y% G; J6 e Q. M' V3 o
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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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