 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$ ?5 G" z( K, M
Final Settlement
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CAR A:
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Maker/Model -
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Plate Number:% X( t3 l1 K0 O" y7 d1 @+ L
Driver Name: (called driver A in this document); P" C( Z, W, x$ u; H
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CAR B:
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Serial (VIN) # -1 C' `9 x3 \0 Q, }
Plate Number:" t; e! A# G+ A, G9 v0 P
Driver Name: (called driver B in this document)# }$ d0 P# k6 f8 h
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In the afternoon of Nov. 7th, 2007, car B hit the back of car A." H s5 p+ A+ h) c7 D) M! _( f
6 Z2 g7 N/ J% k w4 \The driver B has paid
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2. Other Compensation: $9 y, h% V1 u9 m. q# @
& ]1 p; \7 @- T2 z9 [3 A 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.
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Signature Date:
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Signature Date:, U# ?: m6 \7 \% Z! J/ [ T
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# _1 j; j9 f& ^. {5 XWitness:
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( [+ P0 ~* c, v! B/ U* w% m; d) d; ASignature Date: |
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