The undersigned, __________, having failed to pay for certain merchandise, more specifically described as follows __________, hereby agrees to pay, within 60 days of the date this agreement is signed, civil damages up to $400, plus the merchandise or the replacement value of the merchandise. The parties agree that this payment shall constitute full and complete payment of damages to the following establishment __________. The following establishment __________ agrees to waive any and all claims it may have for civil damages.
Nothing in this agreement shall constitute an admission of guilt for purposes of criminal law. If this agreement is signed and payment is made in full within 60 days, no police report or criminal complaint will be filed by the merchant relative to this incident. However, nothing in this agreement can or will bar the state of New Hampshire from instituting such criminal prosecutions as it deems necessary.
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Party #1 |
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Party #2 for the following establishment: |
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RSA 544-C:1
1992, 106:2. 2006, 84 : 1 , eff. July 4, 2006. 2009, 209 : 7 , eff. Jan. 1, 2010.