 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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! R, P6 P/ d0 P$ ~) @4 {Settlement Disclosure, @2 K9 f S- N; ?5 }
Final Settlement
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CAR A:
2 g* l2 {1 v+ x+ | A6 @' BYear -
2 d; {( f- H& O' GMaker/Model -$ D& K/ F4 M/ Z0 a3 ^
Serial (VIN) # -/ R. _$ G; L& z% I
Plate Number:
, E0 e0 G, v1 f! I% eDriver Name: (called driver A in this document)
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CAR B:. s8 o8 {6 }4 \( O- d5 G2 {" V% S
Year -2 k1 t Z& X/ [0 }# l. a+ C2 Y
Maker/Model –
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Plate Number:: X u/ d# w0 N
Driver Name: (called driver B in this document)
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0 v" c3 N+ K6 ^- D% a9 PIn the afternoon of Nov. 7th, 2007, car B hit the back of car A.8 K+ V4 ?- X, `% h. z3 M
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The driver B has paid- b& ], N" e4 X
1. Bumper repair: $
9 \* {5 u6 K' \2. Other Compensation: $
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- h1 j* F& B" A/ L; 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./ D/ n# u/ c' `, t2 H
6 u. R! w. E. E0 F$ {' D/ mDriver A:: _, G- W0 L* i) Y* G
- R9 M6 t/ |4 c9 x7 k2 q# hSignature Date:
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; ^! N- r) }/ }0 tDriver B:
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Signature Date:
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) g5 j4 F* y: O( `Witness:. D1 g& I. @9 R( D8 E4 c; y# r
/ L- {8 y i7 y; ZSignature Date: |
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狗仔卡
发表于 2008-3-11 09:16
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