 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。6 n9 U* M/ i. `' p! F7 ?
& I* a9 p& T6 u5 O- _, Q* `+ ZSettlement Disclosure0 F* A8 b5 [# M3 N9 T( B1 y' p
Final Settlement! Q; w- P% c0 J$ L! o
! `. t' W! J5 E# }8 Q& u2 N9 ?- U$ aCAR A:
2 `3 y+ [& z7 r# NYear -
9 t( M0 ~" b$ u$ i1 [Maker/Model -
: m) z: I# b* Y0 tSerial (VIN) # -) ]- \: b6 _0 w7 J" h A9 X
Plate Number:
' {" x; ?# m9 t) j- pDriver Name: (called driver A in this document)
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CAR B:! m* n( d; H/ _
Year -8 z7 j S' K4 ^! l* e/ p1 C
Maker/Model –% x+ W7 R2 m7 e) G$ Z! Z: \$ i: `4 B
Serial (VIN) # -8 }& D& ]# U+ g/ P
Plate Number:
3 b% p- C- R) s7 [. S1 b/ \Driver Name: (called driver B in this document)) W1 B5 m4 R& u7 g
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In the afternoon of Nov. 7th, 2007, car B hit the back of car A.8 \9 q! _# n, g6 M1 p
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The driver B has paid9 j& ]7 d. A7 ]/ H* E
1. Bumper repair: $
N' I7 ?) T& h& x/ g t- }$ k2. Other Compensation: $
6 U1 ]. D. w0 F1 ^9 O4 @
! \! N9 v8 \8 ?2 h: o' rdriver 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.: s# x) s! ~$ B6 q
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Driver A:% V- R- o/ i2 W0 Q% x/ }
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Signature Date:! q" | H- r# p1 X
& K4 ]7 u- U }& ~' H' e+ B1 _7 A7 a2 Q
Driver B:1 \, v* o1 a, w( ]/ _* ^1 U3 j- t
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Signature Date:
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% O9 w% Z& j* z* i5 }Witness:- `5 _# c- H# }- g) E" A( F
0 A0 J$ X/ H+ F. Y6 h9 CSignature Date: |
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狗仔卡
发表于 2008-3-11 09:16
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