3520-29 MVECP Miscellaneous Payments Due Form

EPA Form#:3520-29
OMB No. 2060-0104

U.S. Environmental Protection Agency
Motor Vehicle and Engine Compliance Program
Miscellaneous Payments Due Form
Date:
Manufacturer Name:
Check here if IMO/Annex Engine Family:
Engine Family Name:
Original Payment Date:

Original Check#/Wire/ACH/Pay.gov Tracking Number:

Original Amount Paid:

(optional)

$

Revised Engine Family Name:

(optional)

Authorized Company Representative:
Contact Name:

Phone:

Email Address:

Fax:

(optional)

Reason for Payment:
Incorrect/Revised engine family
Underpayment
New calendar year fee schedule change
Annual Model Year Reduced Fee Payment Report
Other
Comments:

Annual Model Year Reduced Fee Payment Report

Only use this form if each family has fewer than 6 vehicles, and each engine/vehicle is less than $75,000. You must
include all certificates issued for model year.

Engine Family Name:

Amount
Previously
Paid:

Number of
Engines/Vehicles in
Family:

Project Aggregate
Retail Sales Amount: Total Fees Due:

Amount Owed/Due:

Engine Family 1
Engine Family 2
Engine Family 3
Engine Family 4
Engine Family 5
Engine Family 6
Engine Family 7
Engine Family 8
Engine Family 9
Engine Family 10
Engine Family 11
Engine Family 12
Engine Family 13
Engine Family 14
Engine Family 15
Totals:
Fee Payment Details
Amount Owed

Current Form Expires: 1/1/07
$

Payment Type:
Enter the check number:

MVECP Miscellaneous Payments Due Form
Instructions:
Manufacturer Name:
Check Here if IMO/Annex Engine Family:
Engine Family Name:
For these three items, enter the manufacturer's name and the original engine family or test group name. If the engine name is for an IMO/Annex
certification, check the box. If payment is being made on an engine family older than the current model year minus one, contact your
certification representative. If you are using this form to submit an Annual Model Year Reduced Fee Payment Report, enter any relevant engine
family name.
Original Payment Date:
Enter the date of the original online payment or of the offline payment by check, wire or ACH. Use the best information available. If you are
using this form to submit an Annual Model Year Reduced Payment Report, enter today's date.
Original Amount Paid:
Indicate the amount you have already paid for this engine or test group.
Original Check #/ Wire/ACH/Pay.gov Tracking Number:
Enter the original check number, or indicate "Wire" or "ACH" if the original offline payment was by those methods. Enter the Pay.gov
Tracking ID number assigned for the original payment if it was online. This information will help EPA confirm the original payment
information.
Revised Engine Family Name:
Enter a revised engine family name if payment is owed because an engine family name has been changed or corrected to a category requiring a
higher fee than originally paid. It will also be necessary to fill out a Fees Correction Form, which is available online from Pay.gov.
Reasons for Payment:
Select from the following options:
-- Incorrect/Revised engine family: If an underpayment was made because the wrong engine family certification was originally
applied for, and/or the original engine family is being revised to a different family with a different certification fee payment requirement, select
this button, enter the amount of the shortfall in the Amount Owed box at the bottom of the form, and add any explanation in the Comments
box. Indicate that the corresponding Fee Correction Form has been filed. Include the revised engine family name in the space provided above
for Revised Engine Family Name.
-- Underpayment: If the original payment did not cover the full required amount, select this button, enter the amount of the shortfall
in the Amount Owed box at the bottom of the form, and add any explanation in the Comments box.
-- New calendar year fee schedule change: New certification fees are calculated for each calendar year. The fee that applies to an
engine is determined by the calendar year in which a complete application is received. If a manufacturer or ICI owes EPA due to a fee schedule
change, select this button, enter the amount of the shortfall in the amount due box and add any explanation in the Comments box. If EPA owes
the manufacturer or ICI due to a fee schedule change, use the Fees Correction Form or Fee Refund Form.
-- Annual Model Year Reduced Fee Payment Report: 40 CFR 85.2406(e) requires some reduced fee certificate holders to submit a
reduced fee payment report annually within thirty days of the end of each model year. Selecting this button will cause a form for such a report
to appear. This form may be used for the annual report and to pay the difference between the initial reduced fee and the final calculation. If the
initial fee payment exceeds the final reduced fee then the manufacturer or ICI may request a refund using the Fee Refund Form.
-- Other: Select this button for any other underpayments, enter the amount to be paid in the amount due box, and explain in the
Comments box.
Comments:
Enter any comments that are necessary or useful to explain the payment.
Fee Payment Details:
Amount Owed:
Enter the amount owed.
Payment Type:
Select one of the five payment options listed: Online ACH, Online Credit Card, Offline ACH, Offline Wire, or Offline Check. If paying offline
by check, enter the check number.

-- For offline payments:
Before submitting, please make a copy of the form for your own records and to remember the amount to be paid, by printing from the PDF
version after selecting the PDF Preview button. (The form can also be saved as a computer file by using the Save A Copy icon on the Adobe
taskbar.) After copying the PDF version, use the backspace button on your browser to return to the form so that it can be submitted.
Submit Data
If paying online has been selected, pushing this button will take you to a plastic card or an ACH debit summary page for submission of
payment. Please make sure all information is correct before submitting data. Once the "Submit Data" button is selected, changes cannot be
made. The browser's backspace key cannot be used to make modifications to the form.
After payment is made, a Payment Confirmation will appear that can be copied for your records. A payment summary will also be sent
automatically to your email address. The Payment Confirmation lists the engine family along with the other payment information; the summary
sent to your email address does not. It is a good idea to make a copy of the Payment Confirmation.
If payment offline was selected, pushing the Submit Data button will take you back to the forms list; payment will be the responsibility of the
manufacturer/ICI according to the instructions at http://www.epa.gov/otaq/fees.htm. Those instructions are summarized below. Before
submitting, please make a copy of the form for your own records, and to remember the amount to be paid, by printing from the PDF version
after selecting the PDF Preview button. The form can also be saved as a computer file by using the "Save A Copy" icon on the Adobe taskbar.
- To pay offline by check, after submitting the form online: Make the check payable to "U.S. Environmental Protection Agency". Write
"MVECP fee" and the engine family or test group name on the check, or, if the check is for multiple test groups or engine families, write
"MVECP for ___ engine families/test groups" (edit number as appropriate). Mail the check to:
Environmental Protection Agency
Motor Vehicle and Engine Compliance Program
P.O. Box 954472
St. Louis, MO 63195-4472
If using a private shipping service such as Federal Express (or other service), send checks to:
US BANK
Government Lock Box Division
Mail Station SLMOC1GL, Operations Center
1005 Convention Plaza
St. Louis, MO 63101-1200
- To pay offline by wire, after filing the form online: Electronic Funds Transfer wire payments through the New York Federal Reserve Bank
are the only wire transactions normally accepted for certification fee payments. Fedwire payments are not normally accepted. EFT/wire
transactions must be arranged with the manufacturer's bank. The bank will need the following information:
The EPA location code is 68010099.
The ABA# is 021030004.
The manufacturer must submit the following information in the EFT/wire message field (maximum 80 columns):
Description: "EPA MVECP FEE"
Standard Engine Family or Test Group Name (s)
Corporate Name.
- To pay offline by Automated Clearing House Electronic Funds Transfer (EFT/ACH) after filing the form online: To set up an EFT/ACH
payment method, the manufacturer should contact its bank, which will make arrangements with the US Bank. At this time, the US Bank can
only receive EFT/ACH payments from banks in the United States. The bank will need the following EPA routing and account information:
RDFI- US Bank
Routing Transit # 081000210
Receiving Account # 1001091030
Account Name: U.S. Environmental Protection Agency (EPA)
The manufacturer must submit the following information:
Description: "EPA MVECP FEE"
Standard Engine Family or Test Group Name (s)
Corporate Name.