 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 n2 }2 {0 s4 J/ Z! `1 O; e2 Z7 ASettlement Disclosure
' g: i0 N2 u' v5 R) lFinal Settlement1 O, r3 P/ Y) z8 m6 I- W
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CAR A:
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Maker/Model -
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Plate Number:
4 I. l2 k2 j7 w) s0 N' U) cDriver Name: (called driver A in this document)
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CAR B:- s9 q5 t7 E$ P$ X1 J* T2 m
Year -
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8 s! Z6 W4 ~4 ~% a7 F9 z0 F2 ^1 x+ hPlate Number:
1 g* L4 N7 b4 S- Y5 D, a3 gDriver 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.) C3 S$ G3 K8 a5 N
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The driver B has paid
( q6 N z6 Z+ x9 s; [: P1. Bumper repair: $
) i( J1 j. M9 b9 M/ G' u" i I2. Other Compensation: $
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! W3 Y* _) _* S2 bdriver 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:
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Driver B:
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Signature Date:
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# M$ o6 t5 W0 K. yWitness:3 r' l1 f X2 D" j; ?
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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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