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— D E C L A R A T I O N —

OMB No. 2127-0002

Importation of Motor Vehicles and Motor Vehicle Equipment Subject to

US Department

Public Law 100—562,

of Transportation

15 USC 301

Federal Motor Vehicle Safety, Bumper and Theft Prevention Standards

National Highway

Traffic Safety

Administration

PORT OF ENTRY

CUSTOMS PORT CODE

CUSTOMS ENTRY NO

ENTRY DATE

MAKE OF VEHICLE

MODEL

YEAR

VEHICLE IDENTIFICATION NUMBER (VIN)

REGISTERED IMPORTER NAME AND NHTSA REGISTRATION NUMBER (Required when Box 3 is checked)

VEHICLE ELIGIBILITY NO. (Box 3)

DESCRIPTION OF MERCHANDISE IF MOTOR VEHICLE EQUIPMENT

d. I will obtain from the Office of Foreign Missions of the State Department, before

1. The vehicle is 25 or more years old or the equipment item was manufactured on a

departing the United States at the conclusion of a tour of duty, an ownership title to

date when no applicable Federal Motor Vehicle Safety, or Theft Prevention Standard

the vehicle good for export only; and

was in effect. [591.5(i)]

e. I have attached a copy of my official orders. [591.5(h)(1)]

2A. The vehicle, chassis-cab or equipment item conforms with all applicable Federal

Motor Vehicle Safety Standards (or the vehicle does not conform solely because

Name of Embassy: ___________________________________________________

readily attachable equipment items which will be attached to it before it is offered for

sale to the first purchaser for purposes other than resale are not attached), and

Attachment: Copy of Official Orders.

Bumper and Theft Prevention Standards, and bears a certification label or tag to that

effect permanently affixed by the original manufacturer to the vehicle or chassis-cab,

7. The vehicle or equipment does not comply with all Federal Motor Vehicle Safety and

or affixed by the manufacturer to the equipment item or its delivery container in

Bumper Standards, but is being imported solely for the purpose of research,

accordance with applicable National Highway Traffic Safety Administration (NHTSA)

investigations, show or display, demonstrations or training, or competitive racing events,

regulations [591.5(b)]; or

and I state that I will comply with the applicable restrictions on importers of such

merchandise [591.7] and I will provide the Administrator with documentary proof of

Attachment: For chassis-cab entry, see Box 9.

export or destructions not later than 30 days following the end of the period for which

the vehicle has been admitted into the United States. [591.5(j)]

2B. The vehicle conforms with all applicable Federal Motor Vehicle Safety Standards of

Canada and the United States except for minor labeling requirements, and I am

Attachment:

importing it for personal use.

a. Copy of NHTSA permission letter if the importer is not an original manufacturer

Attachment: Copy of manufacturer's confirmation letter.

of motor vehicles (or a wholly owned subsidiary thereof) that are certified to comply

with all applicable Federal Motor Vehicle Safety Standards (FMVSS). Use on the

3. The vehicle does not conform with all applicable Federal Motor Vehicle Safety and

public roads must be authorized specifically. [591.6(f)(1) or (2)];

Bumper Standards, but does conform with applicable Federal Theft Prevention

Standards, but I am eligible to import it because NHTSA has determined that the

b. Importer's statement describing the use to be made of the vehicle or equipment

model and model year of the vehicle to be imported is eligible for importation into the

item if the importer is an original manufacturer of motor vehicles (or a wholly owned

subsidiary thereof) that are certified to comply with all applicable FMVSS. If use on

United States and I have furnished a bond, which is attached to this declaration, in

the public roads is an integral part of the purpose for which the vehicle or equipment

an amount equal to 150 percent of the entered value of the vehicle as determined by

item is imported, the statement shall describe the purpose which makes such use

the Secretary of the Treasury. If the Administrator of NHTSA determines that the

necessary, state the estimated period of time during which use of the vehicle or

vehicle has not been brought into compliance with all such standards within 120 days

equipment item on the public roads is necessary, and state the intended means of

after importation, then I state that I will deliver such vehicle to the Secretary of the

Treasury for export, or abandon it to the United States [591.8]; and that

final disposition (and disposition date) of the vehicle or equipment item after

completion of the purpose for which it is imported. [591.6(f)(3)]

a. I have registered with NHTSA pursuant to 49 CFR Part 592 and such registration

has not been revoked or suspended; or

8. This vehicle was not manufactured primarily for use on the public roads and thus is

not a motor vehicle subject to the Federal Motor Vehicle Safety, Bumper and Theft

b. I have executed a contract or other agreement, which is attached to this

Prevention Standards or the equipment item is not a system, part, or component of

declaration, with an importer who has registered with NHTSA and whose registration

a motor vehicle and thus is not an item of motor vehicle equipment subject to the

has not been suspended or revoked. [591.5(f)]

Federal Motor Vehicle Safety Standards. [591.5(a)]

Attachments: Copy of DOT Bond; and

Copy of Contract with a Registered Importer, if applicable.

Attachment: Importer's substantiating statement. [591.6(a)]

4. The vehicle or equipment does not comply with all applicable Federal Motor Vehicle

9. The vehicle or equipment item requires further manufacturing operations to perform

Safety, Bumper and Theft Prevention Standards, but is intended solely for export and

its intended function, other than the addition of readily attachable equipment items

is labeled for export on the vehicle or equipment item, and the outside of any

such as mirrors, wipers, or tire and rim assemblies, or minor finishing operations

container of the vehicle or equipment item bears a label or tag to that effect.

such as painting, and any part of such vehicle that is required to be marked by Part

[591.5(c)]

541 of this chapter is marked in accordance with that part. [591.5(e)]

Attachment: Statement issued by the manufacturer of the incomplete vehicle,

5. The vehicle or equipment does not comply with all applicable Federal Motor Vehicle

chassis-cab or equipment item which indicates the applicable Federal Motor Vehicle

Safety, Bumper and Theft Prevention Standards, but I am eligible to import it

Safety Standard(s) with which the vehicle or equipment item is not in compliance, and

because:

which describes the further manufacturing required. [591.6(b)]

a. I am a nonresident of the United States and the vehicle is registered in a country

10. Reserved

other than the United States;

b. I am temporarily importing the vehicle for personal use for a period not to exceed

11. The equipment item is subject to the Theft Prevention Standard and is marked in

I year, and will not sell it during that time; and

accordance with the requirements of 49 CFR 541. [591.5(k)]

c. I will export it not later than the end of 1 year after entry, and the declaration

12. The vehicle does not conform with all applicable Federal Motor Vehicle Safety

contains my passport number and country of issue. [591.5(d)]

Standards, but I am eligible to import it because:

d. Passport No. ___________________ Country of Issue ___________________

a. I am a member of the armed forces of a foreign country on assignment in the

United States;

6. The vehicle does not conform with all applicable Federal Motor Vehicle Safety

Standards, but I am eligible to import it because:

b. I am importing the vehicle on a temporary basis, and for my personal use;

a. I am a member of the foreign government on assignment in the United States, or

c. I will not sell the vehicle to any person in the United States;

a member of the Secretariat of a public international organization so designated

under the International Organizations Immunities Act, and within the class of persons

d. I will export the vehicle upon departing the United States at the conclusion of a tour

for who free entry of motor vehicle has been authorized by the Department of State;

of duty; and

b. I am importing the motor vehicle on a temporary basis for my personal use, and

e. I have attached a copy of my of official orders. [591.5(h)(2)]

will register it through the Office of Foreign Missions of the Department of State;

Attachment: Copy of Official Orders.

c. I will not sell the vehicle to any person in the United States, other than a person

eligible to import a vehicle under this paragraph;

NAME OF IMPORTER (Please type)

IMPORTER'S ADDRESS (Street, City, State, Zip Code)

NAME OF DECLARANT {Please type)

DECLARANT'S ADDRESS (Street, City, State, Zip Code)

DECLARANT'S CAPACITY

DECLARANT'S SIGNATURE

DATE SIGNED

HS-7 (Rev. 9-99)

OVER

75124 –M34d

Omb No. 2127-0002 - Importation Of Motor Vehicles And Motor Vehicle Equipment Subject To Federal Motor Vehicle Safety, Bumper And Theft Prevention Standards

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