Epa Form 3520-1 - U.s. Environmental Protection Agency Declaration Form - 2001

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Form Approved OMB 2060-0095 Approval Expires 8/31/03
United States Environmental Protection Agency
Declaration Form
Importation of Motor Vehicles and Motor Vehicle Engines Subject to Federal Air Pollution Regulations
U.S. E.P.A., Certification & Compliance Division (6405-J), 1200 Pennsylvania Ave. N.W., Washington D.C. 20460
Faxback System: (202) 564-9660
This form must be submitted to the U.S. Customs Service (Customs) (42 USC 7522, 7601: 19 CFR 12.73) for each motor vehicle (including
motorcycles, disassembled vehicles, kit cars) and heavy-duty engine (generally, any engine used in a motor vehicle having a gross vehicle weight
rating of greater than 8500 Ibs.) imported into the U.S., except that this form is not required for motor vehicles and heavy-duty engines that are
imported by their original manufacturer and are new and are covered by an EPA certificate of conformity and bear an EPA emission control label.
However one form per shipment may be used, with attachments including all information required to fully describe each vehicle or engine as
below. Check the box below indicating the provisions under which you are importing this vehicle or engine. Before using this form for an offroad
vehicle (code X), the importer must verify that its engine is not subject to nonroad requirements shown on form 3520-21. Note: Although only
code L imports require specific written authorization from EPA, Customs may request EPA review of importer documentation and eligibility for
any import using this form. A nonconforming vehicle that is ineligible for the exemptions or exclusions listed below, must be imported through
an independent commercial importer (ICI) under codes A, C, J, or Z - EPA does not authorize the vehicleís release to the vehicle owner.
Penalties: Any person who knowingly makes any false or fraudulent statement, or omits or conceals a material fact can be fined up to $250,000 or
imprisoned for up to 5 years, or both (18 USC 1001). Any person who improperly imports a motor vehicle (including a motorcycle) or heavy-duty engine may
be fined up to $27,500 per vehicle or engine (42 USC 7524), and may be subject to forfeiture of the entire importation bond, if applicable (40 CFR 85.1513),
and the U.S. Customs Service may seize the vehicle or engine (19 CFR 162.21).
Description and Declaration of Motor Vehicle or Motor Vehicle Engine
1. Port code:
2. Entry date:
3. Customs entry number:
4. Vehicle Identification Number (VIN), or engine and chassis serial no. for HD engine:
5. Manufacture date (mo/yr):
6. Manufacturer (make):
7. Model:
8. ICI imports only, codes A, C, J, Z - EPA no., model year and expiration date of applicable certificate:
Names, Addresses, and Telephone Numbers of Relevant Parties
Certification:
I certify that I have read and understand the purpose of this form, the penalties for falsely declaring information, or for providing misleading information,
or for concealing a material fact. The information I have provided is correct, and all required attachments are appended to this form. I authorize EPA Enforcement
Officers to conduct inspections or testing permitted by the Clean Air Act. I am the owner, importer, or agent for the owner or importer.
9. Importer (must be ICI for
10. Owner:
11. Storage location:
12. Signature:
codes A, C, J, Z):
13. Date:
14. Name, company and phone (type or print):
U.S. conforming and ìidenticalî vehicles
G
code B - U.S. certified - unmodified vehicle bearing a U.S. EPA emission control label in engine compartment (or on motorcycle frame) in English.
G
code F - U.S. certified, catalyst restoration - U.S. certified vehicle as described above, except that the catalyst, oxygen sensors or fuel filler neck
restrictor were removed or damaged. The importer attests that the catalyst and oxygen sensors and fuel filler neck restrictor, as applicable, will be re-installed
or replaced after importation. If leaded gasoline was used, the importer attests that after importation (1) the fuel tank will be drained and refilled with unleaded
gasoline, (2) the catalyst and oxygen sensors, if they were left on the vehicle during use of the leaded gasoline, will be replaced, and (3) the fuel filler neck
restrictor will be checked and replaced as necessary. No bond or EPA approval is required.
G
code EE - identical in all material respects to a U.S. certified version - either 1) Canadian vehicle (proof required e.g. Canadian emission control label,
registration or title, or letter from the U.S. or Canadian manufacturer representative on letterhead verifying manufacture for sale in Canada) on EPA list of
Canadian "identical" models, or 2) vehicle from any country with letter attached to this form from the manufacturerís U.S. representative on letterhead (not a
dealer or mechanic) stating that the vehicle is identical to a U.S. EPA certified version with respect to emissions. The importer attests that vehicle is being
imported for purposes other than resale or lease. For import of ìidenticalî Canadian vehicles for resale, use code FF.
G
code FF - Canadian ìidenticalî models imported for resale or lease
Canadian vehicle as described above appearing on EPA list of Canadian
-
ìidenticalî models, imported for resale or lease. The importer attests that the importer will satisfy applicable labeling, warranty and CAF… requirements as
specified by EPA.
EPA exempted vehicles
G
code M - miscellaneous exemption, either 1) Canadian vehicle as described above (proof required) and the importer is either permanently emigrating to
the U.S. or will reside in the U.S. for greater than one year under a worker or student visa, or 2) Canadian vehicle received by U.S. resident through
inheritance, or 3) EPA hardship letter based on unforseen and extraordinary circumstances is attached to this form.
G
code E - vehicle or engine at least 21 years old (calendar year of manufacture subtracted from year of importation) and in original unmodified
configuration is either exempted or excluded from EPA emission requirements, depending on age. Customs may require proof of vehicle age.
EPA Form 3520-1 (Rev. 11-01) Previous editions are obsolete
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