HS 7a Box 10 Application for Permission to Import a Motor Vehicle for

Application for Permission to Import a Motor Vehicle
for Show or Display
1.

APPLICANT (Owner):
Name: _________________________________________________________________
Phone Number: ______________________ Fax Number: ________________________
Street Address: ___________________________________________________________
_______________________________________________________________________

2.

VEHICLE IDENTIFICATION:
Year: _______ Make: _______________________ Model: _______________________
VIN (or chassis number): _________________________
Date of Manufacture: ________________

3.

Engine: _________________

Current Odometer Reading: _____________

WHERE VEHICLE WILL BE STORED IN THE UNITED STATES:
Street Address: ___________________________________________________________
________________________________________________________________________

4.

ON-ROAD USE:
No: _____ If no, EPA waiver required

Yes: _____ If yes, complete the following:

Name of Independent Commercial Importer (ICI) ______________________________
5.

BASIS FOR APPLICATION:
†
†
†

6.

The vehicle is of technological significance.
The vehicle is of historical significance.
The vehicle is of exceptional significance (if total production exceeded 500 units)

DOCUMENTS ATTACHED
†
Photographs (front, both sides, rear, interior and odometer).
†
Production Verification.
†
Insurance policy limiting vehicle to 2,500 miles annually.
†
Documentation to support historical or technological significance (if the vehicle
has not previously been approved by NHTSA for Show or Display).

HS-7A (Box 10)

7. TERMS OF IMPORTATION
I the undersigned understand that 49 U.S.C. 30114 and appropriate delegations authorize the
National Highway Traffic Safety Administration (NHTSA) to establish terms that NHTSA
decides are necessary for importations for show or display.
If NHTSA agrees to permit my importation for show or display of the vehicle described above,
in consideration of such agreement I agree to abide by each of the following terms that NHTSA
has established, until the vehicle is 25 years old, specifically to:
1.

Create, maintain, and make available at reasonable times for review or copying by
NHTSA the following records for the vehicle:
a.
b.
c.

d.
e.

Title to the vehicle.
A copy of the HS-7 Form and all other relevant importation documents.
A log indicating all locations where the vehicle is shown or displayed, including a
description of any event, event sponsor, and method used to transport the vehicle
to and from the event. I agree that the log will account for the entire exemption
period and give the mileage of the vehicle for each event.
Current insurance policy.
Documents relating to the final disposition of the vehicle.

2.

Provide reasonable access and entry for NHTSA employees to inspect any facility where
I am displaying or storing the vehicle and to any facility where any record or other
document relating to the vehicle is located.

3.

Not sell, lease, or transfer custody of the vehicle unless I have received written
permission from NHTSA. If I wish to sell or transfer permanent custody of the vehicle to
another person, I understand that I cannot sell or transfer the vehicle unless and until that
person has applied for and obtained a new show/display exemption from NHTSA.

4.

Not register the vehicle for use on the public roads.
OR
If the vehicle is registered for use on the public roads, not accumulate more than 2,500
miles on the vehicle in any 12-month period after it has been brought into compliance
with the regulations of the Environmental Protection Agency (EPA).

5.

Not to transfer temporary custody of the vehicle (other than for repair) to another person,
unless the transferee agrees in writing to the terms that I have agreed to in this
application. The written agreement will contains these terms and identify the vehicle by
make, model, model year, and vehicle identification number (or chassis number).

6.

Export or destroy the vehicle if I no longer wish to use it for the purpose of show or
display (and have not sold or transferred it under the terms stated above).

7.

I will not drive the vehicle on public roads until it is in compliance with the requirements
of the Environmental Protection Agency (EPA).

I understand that I must fully comply with the terms I have agreed to above.
I further
understand that if I fail to comply with any of such term, I may be liable for a civil penalty, or
injunctive relief, or both. I also understand that, under 49 CFR Part 578, Civil Penalties, each
violation may result in a civil penalty up to $1,100 per violation. Finally, I understand that if I
fail to comply with regulations of the EPA ( 40 CFR 85.1511) or of the U.S. Customs Service,
the vehicle may be seized by the U.S. Customs Service.

__________________________________________
Prospective Purchaser

_________________
Date