Settlement Form

Customer Name: Email Id: Booking ID/Job ID:

Job Date: City: Pick Up: Drop Off:

Issue: Settlement Amount: Date of Complaint:

In consideration of the above said amount, the customer is mutually agreed with the company to resolve the dispute on the terms and conditions mentioned below:

Terms and Conditions:

On accepting the above said amount, the customer finally settled with the company for the above mentioned dispute.
On accepting the above mentioned amount, the company expects from the customer not to take any legal action against the company or any of the persons connected with the company in any court of law.
The above said settlement is the full and final settlement and thereafter, the company is not liable for any due/loss towards the customer.
On accepting the settled amount, the customer is agreed to withdraw all the cases, if any, filed against the company or any of the persons connected to the company for the above mentioned dispute/loss/damage.
Note: The amount will be refunded in the original payment method only. For eg. If the amount is paid by credit card the amount will be credited back into credit card. If the amount is paid by eftpos/BT/B-pay then the refund will only be processed in bank account.

Please provide the following bank details:

Bank Name Account Name BSB

Account Number

Disclaimer:

On sharing the above bank details, the customer is agreeing upon the above said terms and conditions.
This is an electronic generated document and needs no signature.