Fill and Sign the Agreement Accident Form

Settlement AgreementPage 1 of 2 Settlement Agreement regarding Property Damages due to an Automobile Accident Settlement Agreement Agreement made on the day of , 20 , between of , referred (Name of Claimant) (Street Address, City, County, State, Zip Code) to herein as Claimant and of , (Name of Opponent) (Street Address) , referred to herein as Opponent; (City, County, State, Zip Code) Whereas, On , Claimant suffered property damage as a result of an automobile (Date) accident at the intersection of and (Name of Street) (Name of Street) in , involving Claimant's automobile and an automobile (City, County, State, Zip Code) being driven by Opponent. The damages asserted by Claimant are listed in the attached Schedule of Damages; and Whereas, an action for the recovery of damages in the aggregate sum of $ has been filed in the of and (Name of Court) (Name of County) , as Civil Action No. (Name of State) (Name of Plaintiff) vs. ; and (Name of Defendant) Whereas, Claimant, in good faith, contends that the sole cause of the accident was Opponent's negligence, in that Opponent ; (Describe Alleged Negligence) and Whereas, Opponent, in good faith, contends that he is not liable to Claimant, in that ; and (Set forth Assertions of Opponent) Whereas, the parties are willing to accept a compromise and settlement of the dispute between them, and this Agreement is made for the purpose of settling between the parties the claims and differences arising from the accident described; Settlement AgreementPage 2 of 2 Now, therefore, for and in consideration of the mutual covenants contained in this agreement, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties agree as follows: I. Payment of Claimant. Opponent promises to pay to Claimant $ , to be paid as follows: . (Time and Manner of Payment) II. Release of Right of Action. Claimant releases and discharges for himself, and legal representatives, successors, and assigns of claimant, Opponent, and legal representatives, successors, and assigns of Opponent, from any and all claims, demands, actions, or suits at law or in equity, of any kind or nature, in any manner arising out of the property damage suffered by Claimant in the described accident.Claimant agrees to file a dismissal with prejudice of the above-mentioned legal action against Opponent as Defendant. III. Absence of Admission of Liability. It is understood and agreed that Opponent, by agreeing to this compromise and settlement, in no way admits liability to Claimant of any kind. Claimant understands that Opponent has not agreed or promised to do, or omit to do, any act or thing not contained in this Agreement. WITNESS our signatures as of the day and date first above stated. By: By: (Signature of Claimant) (Signature of Opponent) (Printed Name of Claimant) (Printed Name of Opponent)