Installment Agreement to Pay Accident Damages - ErnestoRomero ... - ernestoromero 2025

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The document is an Installment Agreement for paying damages resulting from a traffic accident in Wisconsin. It outlines the terms under which an uninsured party agrees to make monthly payments to the recipient for property damages and injuries incurred, including details on payment amounts, dates, and consequences of defaulting on payments. A release of liability will be provided upon full payment.
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  1. Click ‘Get Form’ to open the Installment Agreement in the editor.
  2. Begin by entering the 'Accident Date' and 'Accident File Number' at the top of the form. This information is crucial for identifying your case.
  3. Fill in the 'Uninsured Name and Address' section with your details, followed by the 'Name and Address of Party Receiving Payments - Recipient'.
  4. Next, provide the 'Damaged Property Owner Name' and specify the 'Damaged Property Amount'. Ensure accuracy as this affects settlement calculations.
  5. List any 'Injured Person(s) Included in Settlement' along with their respective 'Injuries Amount'.
  6. Indicate payment details: fill in the 'First Payment Date', 'Last Payment Date', and total number of payments. Calculate and enter the 'Total Settlement Amount' and monthly payment amount.
  7. Review all entered information for accuracy before signing. Ensure that both you and any witnesses sign where indicated.

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