3520-29 MVECP Fee Filing Form

U.S. Environmental Protection Agency
Motor Vehicle and Engine Compliance Program Fee Filing Form
Date:

Manufacturer Contact Information:
Manufacturer Name:

Fax Number:

Contact Name:

Email Address:

(optional)

Phone Number:

Calendar Year:
Test Group or Engine Family Name:
For dual U.S. / IMO Marine only, also give IMO name:
Certification Request Type:

On Highway

Nonroad

On-Highway Certification Types:
LDV
LDT
MDPV
HDV

- Light-duty Vehicles (Chassis Certification - Federal Certificate)
- Light-duty Trucks (Chassis Certification - Federal Certificate)
- Medium-duty Passenger Vehicles (Chassis Certification - Federal Certificate)
- Heavy-duty Vehicles (Chassis Certification - Federal Certificate)

HDE

- Heavy-duty Engine (Engine Dynamometer Certification - Federal Certificate)

LD ICI
MDPV ICI
HDV ICI

- Light-duty Vehicles for Independent Commercial Importers
- Medium-duty Passenger Vehicles for Independent Commercial Importers
- Heavy-duty Vehicles for Independent Commercial Importers
- On-highway Motorcycles (includes Independent Commercial Importers)

MOTORCYCLE
LDV
LDT
MDPV
HDV

- Light-duty Vehicles (Chassis Certification -California-Only Certificate)
- Light-duty Trucks (Chassis Certification -California-Only Certificate)
- Medium-duty Passenger Vehicles (Chassis Certification -California-Only Certificate)
- Heavy-duty Vehicles (Chassis Certification -California-Only Certificate)

HDE CALIF-ONLY

- Heavy-duty Engine California - Only Certification

HDV EVAP-ONLY

- Heavy-duty Evaporative System Only

Nonroad Certification Types:
NR CI
NR SI

- Nonroad Engine Compression-Ignition (includes Independent Commercial Importers and excludes Locomotives, Marine and
Recreational)
- Nonroad Spark-Ignition (includes Independent Commercial Importers)

Locomotives - All Locomotives (includes Independent Commercial Importers)
Recreational

- Recreational Vehicles (except marine engines and includes Independent Commercial Importers)

All Marine - (excludes spark-ignition inboard/sterndrive engines and includes Independent Commercial Importers)

Fee Payment Information:
Do you qualify for reduced fee?
Are you an Independent Commercial Importer?
Make of the model(s) (list all that apply, separated by commas):
Model name(s) of vehicle or engine under this engine family/test group (list all that apply, separated by commas):
Year of the vehicle(s) or engine(s) (list all that apply, separated by commas):
VIN(s) of the model(s) (list all that apply, separated by commas. Enter "TBD" if unknown):
Has a certificate been issued?
What is the total number of the vehicles or engines covered?
What is the aggregate total retail value of the vehicles or engines covered?

Payment Details:
Amount Owed (U.S. Funds Only):
Payment Type:
Enter the check number:

$

$