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Get AK Form 465 2009-2024

________________ INVOLVED PARTIES TERMS OF AGREEMENT Printed Name: ____________________________________________________________________________________ Amount of Settlement: ________________ Amount Received as of This Date: ____________________ Payment Due Each Month By: __________ Amount of Monthly Payment: _________________________ Whereas the involved parties listed above were involved in a motor vehicle crash, and it is desired on the part of both parties that a settlement be reached. .

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