 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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p2 F1 |+ v" KSettlement Disclosure
* ]6 @) t" r5 c$ ~Final Settlement
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CAR A:, q m( s/ a5 {: y) t
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Serial (VIN) # -: D6 Q/ ~: V! ^/ H9 P$ M
Plate Number:" `1 s0 f% F* `; }" L
Driver Name: (called driver A in this document)/ s& l' ]% X. r8 _) G
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CAR B:% j* r: ]: t& B" E- E
Year -
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Driver Name: (called driver B in this document)7 P: }6 R* B, ^2 B q
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In the afternoon of Nov. 7th, 2007, car B hit the back of car A.
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4 [! y9 ?+ @$ \. Z! i5 m% o1 VThe driver B has paid
% N$ i' ]; o8 K8 V' m7 `1. Bumper repair: $8 Y( E3 @4 J. ?8 n# @1 h2 A
2. Other Compensation: $6 J# }, @3 u6 B. p! [. h9 i( D
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driver A and driver B agree to make a final and permanent settlement of this accident. Driver A has received the above amount of money. And Driver A agrees with this final settlement and is forever giving up the right to claim any responsibility of driver B or to proceed to judicial review by a court, concerning any result of this accident for damage of car A or injury of anyone in it.6 ~9 S! D) |/ L7 P
/ g( R% [9 ]3 `9 ?/ q. cDriver A:
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+ P$ O1 D5 K" q% `/ pSignature Date:( [: f, Y# W7 k4 e2 H! U- p
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Driver B:
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3 i& [+ W. G& g. m# USignature Date:' R( B$ ]) g2 G! p
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Witness:
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Signature Date: |
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