Importation of a Motor Vehicle
Under Box 8 on the HS-7 Form
IMPORTER OF RECORD Company: _________________________________________________
Contact Person: _________________________________ E-Mail Address: ______________________
Street Address: ______________________________________________________________________
City: ______________________________________ State: __________ ZIP: ____________________
Tel: (_______) ___________________________ Fax: (_______) _____________________________
BROKER INFORMATION Company: _________________________________ Filer Code: ______
Contact Person: _________________________________ E-Mail Address: ______________________
Street Address: ______________________________________________________________________
City: ______________________________________ State: __________ ZIP: ____________________
Tel: (_______) ____________________________ Fax: (_______) ____________________________
VEHICLE INFORMATION Make: _________________________ Model: _____________________
Model Year: ____________ VIN: _______________________________________________________
OFF-ROAD USE AND FEATURES ____________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Photos should be attached showing the vehicle and its off-road features.
For questions call or mail: U.S. Department of Transportation
(202) 366-5291 National Highway Traffic Safety Administration
E-mail request to:
1200 New Jersey Avenue, S.E.
West Building, Room W45-205, Mail Code NEF-230
Washington, DC 20590
Importcertification@dot.gov
NOTE: If importing more than one vehicle, attach an addendum with model year, make, model,
and VIN for each vehicle. All sections of this form must be complete and submissions in writing
must be legible (49 CFR Part 551.31). All requests submitted to this office must allow 30
business days for determination.
PAPERWORK REDUCTION ACT STATEMENT: A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of
the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2127-0002. The information collected on this form is necessary to obtain a letter from NHTSA
acknowledging that a vehicle was not primarily manufactured for use on public streets, roads, and highways, and is therefore not a motor vehicle subject to the Federal motor vehicle safety standards. The information is used to verify that the vehicle is eligible to be
imported on this basis. We estimate that it will take approximately 5 minutes to complete the form. The information collected is necessary to obtain a benefit under 49 CFR 591.5(e). Send comments regarding this burden estimate or any other aspect of this collection
of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, National Highway Traffic Safety Administration, 1200 New Jersey Ave, S.E., Room W45-205, Washington, DC, 20590.