 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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Settlement Disclosure
/ o5 y" c% n9 CFinal Settlement" F6 i- Z3 S$ c. o
' A$ c4 W3 K& v0 V' hCAR A:( h9 G+ s$ `# n9 x0 I
Year -4 M; G, }, ]. g" K' U% ? z; t3 H
Maker/Model -6 G; o; {& l( Y6 Z" j; k4 f# g3 C
Serial (VIN) # -2 X% @, j1 y+ B& I( E/ T
Plate Number:
& r1 Y: k9 v4 |0 N0 X/ TDriver Name: (called driver A in this document)
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CAR B:
) {7 b& \- N& C: B/ DYear -! p- G' K: [- \9 Y' i
Maker/Model –
4 j& h: J/ F) ]* PSerial (VIN) # -8 i# p/ N8 w& [* `: j0 Q2 l0 b
Plate Number:- E! c. {: G! z! F- n1 R5 I
Driver Name: (called driver B in this document)
1 ~0 s" \$ d3 l( A5 x" g3 j
$ L- h+ a0 M! F. _, R0 QIn the afternoon of Nov. 7th, 2007, car B hit the back of car A.& f; B8 U$ U6 A6 {! ^, Z% K
# y0 [4 ^8 d+ iThe driver B has paid" N/ x% ^/ E) A; j
1. Bumper repair: $
$ `7 W, w0 v) X9 l: P9 y2. Other Compensation: $2 L+ b6 n/ g3 h2 L5 _
+ r$ {/ f h; [' Zdriver 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.) i V5 f) o# r9 J) @
5 V/ N, P L! t {& b) iDriver A:
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Signature Date:. a' M4 l* a( C' @! u3 y* \
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Driver B:$ n& j9 k1 {! t* N% }6 K
0 T+ A4 M5 ^. |) SSignature Date:6 d) F A/ z- }/ E
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5 D' U4 w9 Y; A0 C& h& KWitness:' g1 B3 G' e! n% Z
% c9 y. I: v# g$ `3 u( dSignature Date: |
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狗仔卡
发表于 2008-3-11 09:16
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