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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. q Y* G0 m% t9 q; M }0 f
Final Settlement# P( @" r0 [" C6 c2 s+ d0 |4 e8 e1 F
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CAR A:
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Maker/Model -
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# E. D) E+ Y' S1 h' QPlate Number:
# v- x* I! o4 \# Z; @& x, aDriver Name: (called driver A in this document)
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CAR B:3 e) t: l t9 O s3 M
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Maker/Model –
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Driver Name: (called driver B in this document)
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In the afternoon of Nov. 7th, 2007, car B hit the back of car A.7 E$ W# d8 ?" }7 ]% I( z `
! T( Z4 y& h* Q BThe driver B has paid4 W4 j z6 i* ]8 M3 U
1. Bumper repair: $3 |! u9 g$ |/ Q+ k! ^6 l
2. Other Compensation: $$ t; v: U$ X$ h: f) \ K
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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.
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* B* k8 j3 p0 R1 I0 N& T7 K. bDriver A:! i) r# d; c8 ^$ r
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Signature Date:
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" a3 C8 C; C+ KDriver B:3 y2 r# s. F2 c" W' }/ h! L
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Signature Date:
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5 Y7 e* R9 X; f8 S& |' uWitness:9 J) F& s/ k# Z1 \- t
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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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