 鲜花( 3)  鸡蛋( 0)
|
这里有一份
自己酌情改改就可以了。. U. ]/ | p: k2 E% r! Y
0 }' s4 U' q4 z7 PSettlement Disclosure6 Z% r* w7 p9 m1 Y+ K1 k* D4 W
Final Settlement
/ \! w& F9 T* \5 T2 e" D8 I2 |7 |* e" v# i0 \: t. x
CAR A:# E$ A ?: n( ?) N6 _! v: g
Year -
$ n4 M# W$ w* N$ \: HMaker/Model -
6 ]' s; z3 ~* t9 o$ @7 l9 V$ h5 n2 jSerial (VIN) # -# G# w2 m4 ~8 o, @; j! S9 C
Plate Number:
+ \0 u. V! D& L' S1 iDriver Name: (called driver A in this document)/ @% ]$ O) I0 p* {5 r, T$ I
8 d' I4 t9 [0 N6 C) [; iCAR B:
8 Q+ M2 U% K2 I$ t( T) oYear -
: `3 \$ X7 q" g1 K% ZMaker/Model –
# k& w% |7 _; \! I0 E X$ ?Serial (VIN) # -' I3 q& i: O' C
Plate Number:% n' G4 r9 r9 Z
Driver Name: (called driver B in this document)
$ ^7 q) @( c( @. M- a5 @( z: I+ f7 Z9 w" t7 c" o4 a5 s
In the afternoon of Nov. 7th, 2007, car B hit the back of car A.
2 T, z# K8 p6 W I5 {- X7 t, @' s+ U( R: H% ^) {
The driver B has paid
! X6 a7 ?3 y, r d% s1 K5 I" p) T$ L1. Bumper repair: $, k" p3 h$ W' E3 g; i3 s
2. Other Compensation: $
) z: c9 H: F- u( u) l% F7 j/ I2 b( A1 x5 |! \/ c
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. `( r/ C: ?+ q8 F6 H# F' p9 {
; O6 \& \; Y; }/ m
Driver A:
% Z- C$ f. ?, G( g1 F2 S# h; ?% O0 M; m
Signature Date:
+ `+ Y9 J1 B* V/ l: j9 f& w1 M( N/ ]* D
& w& I+ l8 Y: |; Z' `0 M }
Driver B:
$ ^, I$ x8 j3 |3 @
1 C* P& F( e$ `3 j# bSignature Date:( X0 Y1 u2 ^# Y' P
7 y: Q# N2 x6 d+ Y$ z. Z7 Y
: T% G) |* u( A+ b$ J) V0 p- p
Witness:1 P/ D: B( X# @
, [! m" _* B' i4 e- oSignature Date: |
|
狗仔卡
发表于 2008-3-11 09:16
提升卡
置顶卡
沉默卡
喧嚣卡
变色卡
显身卡
楼主
