 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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# Y b, M- P5 d% tSettlement Disclosure9 i% t( b6 g1 [5 F5 h
Final Settlement! }& ^. e& Z2 M7 Z, a
* N7 V w# l" WCAR A:
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Maker/Model -
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Plate Number:
7 R; ^) l! H; N/ D+ z2 A: w( MDriver Name: (called driver A in this document)
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; ^' |$ Y) h/ L4 h3 }, NCAR B:
n0 u1 n- m1 D3 B5 T4 c9 E, IYear -. O% m6 U; q p4 e
Maker/Model –
2 {6 T- F7 }( _2 z' LSerial (VIN) # -9 Q0 F8 s. Y' q( y" s6 O
Plate Number:
9 q4 [( }6 z+ O: f1 k$ mDriver Name: (called driver B in this document)
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* s( ^7 r$ _' T0 ^3 D, w9 qIn the afternoon of Nov. 7th, 2007, car B hit the back of car A./ B- G% ]$ b. s1 Z
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The driver B has paid2 {9 D1 v+ k, U4 x& ~, d7 S8 V
1. Bumper repair: $3 d# v! @2 f# [* e( e+ E9 _3 H
2. Other Compensation: $# Y/ B* @9 T* M5 v
4 L2 e5 V# n0 T4 xdriver A and driver B agree to make a final and permanent settlement of this accident. Driver A has received the above amount of money. And Driver A agrees with this final settlement and is forever giving up the right to claim any responsibility of driver B or to proceed to judicial review by a court, concerning any result of this accident for damage of car A or injury of anyone in it.( _' x0 k) x" x! `8 N7 Q1 \
/ m; [8 q$ M0 j( P7 Q/ MDriver A:
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Signature Date:
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Driver B:0 G- P5 @4 {7 P5 ]$ y& p
, } S! l% K; l$ P8 _7 ]" X/ ZSignature Date:
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1 q( [4 y o2 ]! m4 L8 UWitness:8 E( c( v# f$ ?. I0 N2 S$ M
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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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