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Ref No.:___________________________

D07

10 Sin Ming Drive Singapore 575701

Tel: 1800-CALL LTA (1800-2255582) Fax: (65) 65535329

*D07*

APPLICATION / AMENDMENT OF APPLICATION DETAILS FOR TEMPORARY EXIT OF

EXPORT PROCESSING ZONE (EPZ)-VEHICLE

You will require the following information to fill in the form:

● Vehicle Registration Number/ Engine Number/ Chassis Number

● Requested Duration for Temporary Exit of EPZ-Vehicle

● Temporary Storage/ Garage Name(s) & Address(es)

● Company Stamp

● Particulars of EPZ Operator and EPZ Operator’s Customer

● EPZ-Vehicle and Exit Details

NOTE: The application must be submitted to the LTA at least 3 working days in advance of the first intended date of the temporary exit activity(ies).

Section A: Particulars of EPZ Operator

Name of EPZ Operator: ______________________________ Name/ NRIC of Authorized Person*: ______________________________________

Section B: Particulars of EPZ Operator’s Customer

Name of Company: __________________________________________ Company/ Business Registration No.:___________________________

Name/ NRIC of Contact Person: ________________________________Contact No.:_______________________________________________

Section C: EPZ-Vehicle And Exit Details

Vehicle No.: ____________________________________ Make/ Model: ________________________________________________________

Engine No.: ____________________________________ Chassis No.:__________________________________________________________

Temporary Storage/ Inspection Centre/ Garage Name(s), Address(es) & Period of Temporary Exit: (to state all locations during temporary

exit period):

Name

Address

Period of Temporary Exit

Purpose of Temporary Exit

(dd/mm/yy) to (dd/mm/yy)

(E.g. Inspection/ Repair/

(hh/mm) to (hh/mm)#

Repair & Inspection, etc.)

Terms and Conditions

The de-registered EPZ-vehicle can only be stored at the above stated temporary storage/ garage address(es) and all works pertaining to the

temporary exit must be completed within the abovementioned specified period unless otherwise approved in writing by the LTA;

The de-registered EPZ-vehicle shall not be used or kept on public roads or in public places;

The de-registered EPZ-vehicle shall not be driven but shall only be carried or towed from the designated EPZ to the temporary storage/ garage

address(es) and back to the designated EPZ upon the completion of the exit purpose(s) unless otherwise expressly approved in writing by the

LTA; and

This application does not confer any rights of occupation whatsoever of any facilities for the temporary exit of a de-registered vehicle from an

EPZ for any specific purpose.

Declaration

We declare that we have read and understood the Terms and Conditions of this application as stated above and:

The particulars furnished in this application and other supporting documents (if any) are true and correct;

We have full authorisation from the owner of the de-registered vehicle to make this application; and

We jointly and severally agree and undertake to indemnify and to hold LTA in all respects harmless against any losses, actions, demands,

suits, charges, damages proceedings, costs and expenses whatsoever arising from or in connection with this application and the temporary

exit of the de-registered vehicle from an EPZ.

__________________________________

_______________________________

Signature of authorized person (indicated in Section A)

Signature of contact person (indicated in Section B)

/ Date / Company Stamp of EPZ Operator

/ Date / Company Stamp of EPZ Operator’s Customer

For Official Use

This application is approved subject to the Terms and Conditions as stated above and as specified by the LTA, and LTA’s receipt of a valid

Cashier’s Order of an amount of S$____________________.

_______________________

______________________

for Registrar of Vehicles

Date

* Authorized Person means the representative(s) appointed by the EPZ Operator to liaise with the LTA for the purpose of the Agreement signed between the EPZ

Operator and the LTA.

# Both date and time must be completed for inspection requests only.

This information is current at time of printing (August 2010) VRLSO-F-D07-V00

Form D07 - Application/amendment Of Application Details For Temporary Exit Of Export Processing Zone (Epz)-Vehicle

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