HS 7a Box 10 Application for Permission to Purchase a Motor Vehicle P

Application for Permission to Purchase a Motor Vehicle Previously
Granted a Show or Display Exemption Under 44 U.S.C. 30114

1. APPLICANT (prospective purchaser)
Name: ______________________________ Phone Number: __________________________
Fax Number:____________________________
Street Address:_______________________________________________________________
___________________________________________________________________________
Importers Name: ________________________ Phone Number:_______________________
Street Address:_______________________________________________________________
___________________________________________________________________________

2. VEHICLE IDENTIFICATION:
Year: __________ Make: _______________________Model:_________________________
VIN (or chassis number): ___________________________Engine: ____________________
Date of Manufacture: _______________Current Odometer Reading: ___________________

3. WHERE PURCHASER WILL STORE THE VEHICLE IN THE U.S.:
Street Address:_______________________________________________________________
__________________________________________________________________________
4. TERMS OF SALE:
I understand that under 49 CFR 591.7(c) the importer of the Vehicle may not sell the Vehicle
or transfer possession or title to the Vehicle except under such terms and conditions that NHTSA
may establish.
If NHTSA agrees to permit sale of this show or display Vehicle, 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:
1. To create, maintain, and make available at reasonable times for review or copying by NHTSA
the following records for the Vehicle:

a.

Title to the Vehicle.

b.
c.

d.
e.

A copy of the HS-7 Declaration Form under which the Vehicle was imported 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 cover the entire exemption period
and give the mileage of the Vehicle for each event.
Current insurance policy, in my name, limiting use of the Vehicle to 2,500 miles
per year.
Documents relating to the disposition of the Vehicle.

2.

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

3.

To not sell, lease, or transfer custody of the Vehicle unless I have received written
permission from NHTSA. If I wish to sell or transfer possession of the Vehicle to
another person, I understand that I cannot sell or transfer the vehicle unless and until I
receive permission from NHTSA to do so.

4.

To not register the Vehicle for use on the public roads.
OR
If the Vehicle is registered for use on the public roads, to not accumulate more than 2,500
miles on the vehicle in any 12-month period.

5.

To not transfer possession 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 contain these terms and identify the Vehicle by make, model,
model year, and Vehicle identification number (or chassis number).

6.

To 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).

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 $21,000 per violation. Finally, I understand that if I
fail to comply with regulations of the Environmental Protection Agency (EPA)(40 CFR 85.1511)
or of the U.S. Bureau of Customs and Border Protection, as they pertain to the Vehicle, the
Vehicle may be seized by the U.S. Bureau of Customs and Border Protection.

__________________________________
Prospective Purchaser

_______________________
Date